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Cricothyroidotomy is an emergency rescue technique to secure the airway in a 'Can't intubate, Can't Oxygenate' (CICO) situation. The cricothyroid membrane (CTM) is the target site of cricothyroidotomy, and accurate identification of the CTM is essential for successful cricothyroidotomy. In this study, the investigators compare patient positions (neck extension vs. modified ramped position) in terms of the success rate for identifying the CTM in obese patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Neck extension group | Active Comparator | The cricothyroid membrane is identified in a neck extended position. |
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| Modified ramped position group | Experimental | The cricothyroid membrane is identified in a modified ramped position. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Identification of the cricothyroid membrane | Other | The cricothyroid membrane is identified using a laryngeal handshake technique in different patient positions. |
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| Measure | Description | Time Frame |
|---|---|---|
| Success rate for the correct identification of the cricothyroid membrane | After identifying the cricothyroid membrane using a laryngeal handshake technique in different head positions, an assessor evaluates the correctness of its localization using ultrasound. | Immediately after identifying the cricothyroid membrane using a laryngeal handshake technique |
| Measure | Description | Time Frame |
|---|---|---|
| Duration for identifying the cricothyroid membrane | Time taken to locate the cricothyroid membrane is checked. | At 90 seconds after administering neuromuscular blockade |
| Distances between the center of the actual and perceived cricothyroid membrane |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| SMG-SNU Boramae Medical Center | Seoul | Select State/Province | 07061 | South Korea |
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Distances between the center of the actual and perceived cricothyroid membrane is measured using ultrasound.
| Immediately after identifying the cricothyroid membrane using a laryngeal handshake technique |
| Perceived difficulty during cricothyroid membrane identification | Anatomical difficulty perceived by the anesthesiologists during cricothyroid membrane identification is assessed (1, very easy; 2, easy; 3, moderate; 4, difficult; and 5, very difficult). | At 5 minutes after identifying the cricothyroid membrane using a laryngeal handshake technique |