Emergency Cricothyrotomy: Toward a Safer and More Reliable Rescue Method in "Cannot Intubate, Cannot Oxygenate" Situation.

Anesthesiology, V 123 • No 5 995 November 2015 I F oxygenation is difficult due to failed tracheal intubation and difficult ventilation via a facemask after induction of anesthesia, all the major guidelines on “difficult airway management” recommend to insert a supraglottic airway, and if that is ineffective, to gain invasive access to the infraglottic airway (such as cricothyrotomy and tracheostomy) as the last resort.1–3 Nevertheless, this invasive method as the last resort may also fail, rendering the current strategies for difficult airway management not ideal.4 In this issue of ANesthesIology, siddiqui et al.5 have shown that emergency percutaneous cricothyrotomy may frequently produce another lifethreatening complication (tear to the posterior tracheal wall) and that ultrasonography may drastically reduce this complication.