Both tracheostomy and cricothyrotomy help people breathe when airways are blocked. Cricothyrotomy is an emergency procedure while tracheostomy is for people who need long-term assistance with breathing.
Tracheostomy is a surgical technique performed in a hospital under anesthesia or sedation that helps people who require long-term respiratory support.
Cricothyrotomy (also known as cricothyroidotomy), on the other hand, can be performed quickly to give a person immediate access to oxygen. It’s sometimes called “emergency tracheostomy.”
Cricothyrotomy doesn’t require anesthesia but is usually performed with sedatives known as induction agents that will make the person having the emergency unconscious. An example of an induction agent is ketamine.
This article discusses how these procedures differ, what are their purposes, and who the candidates are for each.
Both cricothyrotomy and tracheostomy are performed when a person cannot breathe properly. There are two types of tracheostomy: elective and emergent.
Cricothyrotomy and emergent tracheostomy are used when an airway obstruction is causing breathing problems. There are certain situations in which medical professionals choose one over the other.
An elective tracheostomy is commonly used in cases where someone has been intubated for a prolonged period of time but is unable to wean from a ventilator.
When is cricothyrotomy used?
Cricothyrotomy is typically performed in emergency situations where immediate access to the airway is crucial. It’s often used when there is a sudden blockage or severe injury to the airway. For example, it’s used during:
- a choking incident
- an airway trauma or burn
- anaphylaxis
Doctors, nurses, or paramedics can perform cricothyrotomy.
When is tracheostomy used?
Tracheostomy is usually
- acute respiratory failure
- needing a ventilator to breathe
- certain long-term breathing conditions, such as obstructive sleep apnea
A surgical team typically performs tracheostomy.
Here are the benefits each procedure offers.
Cricothyrotomy benefits
One of the main advantages of cricothyrotomy is its speed and simplicity. Since it’s performed in emergency situations, the procedure can be done quickly. It allows immediate access to the airway, which can be lifesaving during critical medical situations.
Tracheostomy benefits
Tracheostomy, on the other hand, offers long-term benefits. It provides a more stable and secure airway connection. This helps you breathe easier. In addition, after tracheostomy, most people can eat and speak. These actions are usually not possible with a cricothyrotomy.
Both cricothyrotomy and tracheostomy are generally very safe, but they can carry certain risks.
Cricothyrotomy risks
Risks associated with cricothyrotomy are mainly due to the tube insertion or an incorrect incision. Bleeding is the most
Other risks can involve:
- damage to nerves or organs in your throat, such as the windpipe (trachea) or the thyroid gland
- infection
- voice changes or narrowing of your voice box, which can cause high-pitched wheezing (stridor)
Tracheostomy risks
Tracheostomy also carries certain risks, according to the U.K.’s National Health Service. Short-term risks can include:
- bleeding
- collapsed lung
- damage to nerves or organs in your throat
- infection
Long-term risks can include:
- blocked tracheostomy tube
- collapsed or narrowed trachea
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Let’s discuss how cricothyrotomy and tracheostomy procedures are performed.
Cricothyrotomy procedure
During a cricothyrotomy, a medical professional makes an incision through the skin and the soft tissue in the neck that connects the cartilage (the cricothyroid membrane). They then insert a tube into the opening and connect it to the windpipe to maintain the airway.
Tracheostomy procedure
There are two types of tracheostomy procedures: bedside percutaneous tracheostomy and open surgical tracheostomy.
Bedside percutaneous tracheostomy is performed in an intensive care unit (ICU), while open surgical tracheostomy is performed in an operating room.
Surgical teams perform both procedures. Surgical tracheostomy is typically done under general anesthesia, and bedside tracheostomy under sedation.
During tracheostomy, the surgeon makes an incision in the skin on the lower part of your neck. They then pull back the surrounding muscle to locate your trachea. After that, they make an opening in a specific part of the trachea and insert a tracheostomy tube.
Cricothyrotomy is best for people who need immediate access to oxygen due to sudden airway blockage (for example, as a result of choking).
Tracheostomy, on the other hand, is ideal for hospitalized people who need long-term help with breathing.
The costs of cricothyrotomy and tracheostomy vary depending on location, healthcare professional, and other factors. Cricothyrotomy is a less complex procedure, which typically makes it less expensive than tracheostomy.
According to a 2020 study reviewing costs for a North Carolina medical facility, tracheostomy performed in an operating room costs $4,600 on average. Cricothyrotomy is generally significantly cheaper.
Private insurance and governmental programs typically cover both procedures, but be sure to check with your healthcare professional and facility to confirm the details.
Both cricothyrotomy and tracheostomy are considered very effective.
Cricothyrotomy is a lifesaving procedure in emergency situations. Tracheostomy improves the quality of life for people who need ongoing help with breathing.
Endotracheal intubation is the main alternative to cricothyrotomy and tracheostomy. This technique involves inserting a tube into your trachea through the mouth or nose. It’s usually performed during planned surgeries, but it can also be done in an emergency setting.
Cricothyrotomy and tracheostomy are medical procedures that help people with airway obstruction.
Cricothyrotomy is an emergency procedure that provides immediate access to the airway. Tracheostomy is a surgical procedure performed to help with long-term breathing issues.
Both procedures present benefits and risks. Be sure to talk with a medical professional if you have any questions about either procedure.