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Prehospital Emergency Cricothyroidotomy in Denmark: A Nationwide Cohort Study, 2016–2023

Resuscitation·August 24Open Access
Emergency MedicineLimited evidenceFailed Airway ManagementOut-Of-Hospital Cardiac ArrestNationwide Registry-Based Observational Cohort StudyEmergency Airway ManagementMixed

Summary

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What was studied

This nationwide registry-based cohort study examined all prehospital emergency cricothyroidotomies performed in Denmark from 2016–2023, covering patient characteristics, procedural success, and clinical outcomes — including a subgroup of out-of-hospital cardiac arrest (OHCA) patients linked to the Danish Cardiac Arrest Register.

Key findings

71 cases were identified (48 OHCA, 23 non-OHCA); overall procedural success was 87.3% (83.3% in OHCA, 95.7% in non-OHCA). Among OHCA patients, ROSC was achieved in 25.0%, 30-day survival was 4.5%, and 1-year survival was 2.3%. Emergency cricothyroidotomy was performed in only 0.12% of 39,885 nationwide OHCA patients.

Study limitations

- Very small sample size (n=71) limits statistical precision and subgroup analysis. - Observational registry design precludes causal inference. - Findings reflect a physician-staffed EMS system in Denmark and may not generalize to paramedic-led or lower-resource systems.

Clinical implications

Prehospital emergency cricothyroidotomy is exceedingly rare (0.12% of OHCAs) but achieves high procedural success (~87%) when performed by physician-staffed EMS teams. Clinicians should anticipate very poor survival in OHCA patients requiring this rescue airway, and use it as a last resort after failed conventional airway management.

Related Questions

Explore related topics

What is the procedural success rate of emergency cricothyroidotomy in prehospital settings?How does airway management affect survival in out-of-hospital cardiac arrest?What are the indications and outcomes for surgical airway rescue in physician-staffed EMS systems?

Publication Details

Year
2026
Journal
Resuscitation
Sample Size
n=71
Source
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