Accuracy of digital palpation and laryngeal handshake in identification of cricothyroid membrane: An observational study | [Anaesthesia, Pain and Intensive Care • 2020]

Author(s):

1. Khor Whuan Wyeen: Department of Anesthesiology & Intensive Care, Universiti Kebangsaan Malaysia Medical Center. Jalan Yaakob Latif, 56000 Kuala Lumpur, Malaysia

2. Syarifah Noor Nazihah Sayed Masri: Department of Anesthesiology & Intensive Care, Universiti Kebangsaan Malaysia Medical Center. Jalan Yaakob Latif, 56000 Kuala Lumpur, Malaysia

3. Aliza Mohammad Yusof: Department of Anesthesiology & Intensive Care, Universiti Kebangsaan Malaysia Medical Center. Jalan Yaakob Latif, 56000 Kuala Lumpur, Malaysia

4. Azarinah Izaham: Department of Anesthesiology & Intensive Care, Universiti Kebangsaan Malaysia Medical Center. Jalan Yaakob Latif, 56000 Kuala Lumpur, Malaysia

5. Siti Nidzwani Mohammad Mahdi: Department of Anesthesiology & Intensive Care, Universiti Kebangsaan Malaysia Medical Center. Jalan Yaakob Latif, 56000 Kuala Lumpur, Malaysia

6. Nadia Md Nor: Department of Anesthesiology & Intensive Care, Universiti Kebangsaan Malaysia Medical Center. Jalan Yaakob Latif, 56000 Kuala Lumpur, Malaysia

Abstract:

Background: Evaluation of the anterior neck anatomy is essential to identify the cricothyroid membrane (CTM) before invasive surgical airway. This study aimed to compare the accuracy of cricothyroid membrane identification done by digital palpation (DP) method and laryngeal handshake palpation (LHP). Methodology: A total of 52 participants were recruited to perform DP and LHP procedures on study patients. Using fluorescent “invisible” ink, the participants were asked to mark the cricothyroid membrane. The actual level of CTM was identified using ultrasound by the investigator prior to the land marking and the distance between the actual and estimated margin of the CTM was measured. Time taken to identify CTM and the ease of palpation was measured using a 3-point Likert scale. Results: There were 52 patients in total, with 26 obese and equal number of nonobese patients. CTM was correctly identified in 78.8% of cases using both methods. There was no statistically significant difference between DP and LHP in terms of absolute distance to the midline of CTM (p = 0.361), time to CTM identification (p = 0.101) and ease of palpation (p = 0.059). The time required to identify the CTM in male patients were shorter when using the laryngeal handshake technique. Conclusion: Both digital palpation and l aryngeal handshake palpation techniques are comparable in localizing cricothyroid membrane in obese and non -obese patients.

Page(s): 168-174

DOI: DOI not available

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 24, Issue: 2, Year: 2020

Keywords:

Laryngeal handshake palpation , Cricothyroidotomy , CTM landmarking

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