{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T14:24:18Z","timestamp":1777559058567,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,7,13]],"date-time":"2018-07-13T00:00:00Z","timestamp":1531440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    The Difficult Airway Society 2015 guidelines for management of unanticipated difficulties in tracheal intubation in adults have generated much discussion regarding Plan D: emergency front\u2010of\u2010neck access with a scalpel\u2010bougie cricothyroidotomy technique. There is concern that this technique may not provide an adequate pathway for the bougie and subsequently the tracheal tube, especially in obese patients with deeper airway structures. This could lead to the formation of a false passage, trauma and failure. A novel cricothyroidotomy introducer, 8 mm wide and 170 mm long, with a sharp leading edge and guiding channel to pass a bougie into the trachea, has been designed to complement the scalpel cricothyroidotomy technique. A comparison study of the use of this novel introducer with the scalpel technique in a simulated obese porcine laryngeal model demonstrated shorter insertion times (median (\n                    <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>\n                    [range]) 85 (65\u2013123 [48\u2013224]) s vs. 84 (72\u2013184 [46\u2013377]) s, p = 0.030). All 26 (100%) participants successfully performed cricothyroidotomy in the introducer group, whereas only 24 (92%) participants were successful in the scalpel group. The introducer group required fewer attempts to access the trachea compared with the scalpel group (p = 0.046). False passages occurred eight (31%) times in the introducer group compared with 17 (65%) times in the scalpel group (p = 0.022). There were no statistical differences in tracheal trauma (p = 0.490), ease of use (p = 0.220) and device preference (p = 0.240). This novel cricothyroidotomy introducer has shown promising results in securing the airway in an emergency front\u2010of\u2010neck access situation. With robust training, this introducer could potentially be complementary to the scalpel\u2010bougie cricothyroidotomy technique.\n                  <\/jats:p>","DOI":"10.1111\/anae.14321","type":"journal-article","created":{"date-parts":[[2018,7,14]],"date-time":"2018-07-14T02:44:15Z","timestamp":1531536255000},"page":"1235-1243","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Evaluation of a novel cricothyroidotomy introducer in a simulated obese porcine model: a randomised crossover comparison with scalpel cricothyroidotomy"],"prefix":"10.1111","volume":"73","author":[{"given":"C.","family":"Yeow","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Royal Surrey County Hospital Guildford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Greaney","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Royal Surrey County Hospital Guildford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Foy","sequence":"additional","affiliation":[{"name":"Gloucestershire Research Support Service Gloucestershire Royal Hospital Gloucester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"King","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Royal Surrey County Hospital Guildford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Royal Surrey County Hospital Guildford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev371"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew293"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew286"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2011.06936.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13275"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew174"},{"key":"e_1_2_6_8_1","volume-title":"Major complications of airway management in the United Kingdom, Report and Findings","author":"4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway 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