In a failed intubation scenario, an emergency front-of-neck access is planned. The cricothyroid membrane is chosen for needle or scalpel cricothyroidotomy primarily because it is:

• A Located below the thyroid isthmus, avoiding bleeding
• B Lined by stratified squamous epithelium resistant to trauma
• C The widest part of the adult airway, allowing a size 8 tube
• D Superficial, easily palpable, relatively avascular, and free of overlying viscera ✓

Explanation

The cricothyroid membrane lies between the lower border of the thyroid cartilage and the cricoid, is covered only by skin and fascia, contains no major vessels or gland, and is easily identified even in an obese neck. The thyroid isthmus overlies the second and third tracheal rings, making formal tracheostomy slower and more bloody, hence reserved for elective or semi-elective situations. Cricothyroidotomy is a temporising measure pending definitive airway.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.