Patient Positions for Locating the Cricothyroid Membrane

Comparison of Patient Positions for Locating the Cricothyroid Membrane

Cricothyroidotomy is an emergency rescue technique to secure the airway in a 'Can't intubate, Can't Oxygenate' (CICO) situation. The cricothyroid membrane (CTM) is the target site of cricothyroidotomy, and accurate identification of the CTM is essential for successful cricothyroidotomy. In this study, the investigators compare patient positions (neck extension vs. modified ramped position) in terms of the success rate for identifying the CTM in obese patients.

Study Overview

• Status: Completed
• Conditions: Cricothyroid Membrane
• Intervention / Treatment: Other: Identification of the cricothyroid membrane

• Study Type: Interventional
• Enrollment (Actual): 116
• Phase: Not Applicable

Contacts and Locations

Study Locations

• South Korea
  • Select State/Province
    • Seoul, Select State/Province, South Korea, 07061
      • SMG-SNU Boramae Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 19 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• body mass index >30 kg/m2

Exclusion Criteria:

• anatomical abnormalities or pathologies of the neck
• a history of neck surgery
• cervical spine disorders
• skin lesions on the neck

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Neck extension group; The cricothyroid membrane is identified in a neck extended position.	Other: Identification of the cricothyroid membrane; The cricothyroid membrane is identified using a laryngeal handshake technique in different patient positions.
Experimental: Modified ramped position group; The cricothyroid membrane is identified in a modified ramped position.	Other: Identification of the cricothyroid membrane; The cricothyroid membrane is identified using a laryngeal handshake technique in different patient positions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Success rate for the correct identification of the cricothyroid membrane	After identifying the cricothyroid membrane using a laryngeal handshake technique in different head positions, an assessor evaluates the correctness of its localization using ultrasound.	Immediately after identifying the cricothyroid membrane using a laryngeal handshake technique

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Duration for identifying the cricothyroid membrane	Time taken to locate the cricothyroid membrane is checked.	At 90 seconds after administering neuromuscular blockade
Distances between the center of the actual and perceived cricothyroid membrane	Distances between the center of the actual and perceived cricothyroid membrane is measured using ultrasound.	Immediately after identifying the cricothyroid membrane using a laryngeal handshake technique
Perceived difficulty during cricothyroid membrane identification	Anatomical difficulty perceived by the anesthesiologists during cricothyroid membrane identification is assessed (1, very easy; 2, easy; 3, moderate; 4, difficult; and 5, very difficult).	At 5 minutes after identifying the cricothyroid membrane using a laryngeal handshake technique

Collaborators and Investigators

• Sponsor: SMG-SNU Boramae Medical Center

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2022
• Primary Completion (Actual): December 30, 2024
• Study Completion (Actual): December 30, 2024

Study Registration Dates

• First Submitted: August 31, 2021
• First Submitted That Met QC Criteria: September 8, 2021
• First Posted (Actual): September 13, 2021

Study Record Updates

• Last Update Posted (Actual): December 11, 2025
• Last Update Submitted That Met QC Criteria: December 10, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: 08-2021

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No