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27/05/2014

Maîtrise de la coniotomie en environnement austère: Une nécessité.

Optimizing Emergent Surgical Cricothyrotomy for use in Austere Environments

HessertMJ et Al. Wilderness Environ Med. 2013 Mar;24(1):53-66

Although cricothyrotomy is becoming less common as other alternative airway devices are introduced, such as the laryngeal mask airway, King LT-D (King Systems Corp, Noblesville, IN), and other supraglottic devices, there is, and likely always will be, a role for cricothy- rotomy in a subsection of patients with difficult airways, especially in environments in which such devices are unlikely to be available. A common emergency medicine aphorism is: “If you do one cricothyrotomy, you’re a hero; if you do two, work on your airway skills.” True perhaps in a hospital, but in an austere environment many factors besides failed ET intubation lead to early cricothyrotomy. Wilderness providers must be not only technically skilled, but also adequately trained to recognize the key indications and situational decision triggers for cricothyrotomy that differ from in-hospital practice."

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