Question 3 of 18

This MRCS Part B station tests your knowledge of the anatomy of the thyroid gland and surrounding structures. For more Anatomy practice, head to Acland's via the link above (Pass the MRCS members get access for free)

How would you perform a needle cricothryroidotomy?

- This is an emergency procedure in a "can't intubate, can't ventilate" scenario.

-  I would maintain asepsis throughout as much as possible. I would prepare a 14G needle connected to a 5/10ml syringe half-filled with sterile water. 

- If I could safely extend the neck I would do so and palpate the cricothyroid recess between the thyroid notch and cricoid cartilage. 

- Whilst holding the larynx firmly I would insert in needle into the midline of the recess aiming caudally and continually aspirate watching for air bubbles in the syringe.  Once bubbles are seen I would remove the syringe and needle and repeat the aspiration to ensure air is entering the syringe freely. Once placement is confirmed, I would attach to an oxygen supply.

- I would ensure help was on its way so that a more definitive airway could be established.