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.
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.
- 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.
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.
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