Urgent infraglottic airway - cricothyroid puncture, cricothyrotomy and bougie-assisted cricothyrotomy (BACT)
Abstract
Infraglottic needle/cannula insertion and surgical approaches to the trachea are the last resort choices of providing a patent airway, oxygenation and ventilation in patients where conventional techniques have failed. The main indication, especially in anaesthesia, is "can not intubate, can not oxygenate" situation.
Infraglottic approaches may be the primary technique of providing patent airways in facial trauma, tumours, swelling, or in military medicine. Teaching and regular training on cadavers or models are key elements in managing these life-saving techniques, especially because their real frequency is extremely low.
This review article discusses individual techniques - cricoid puncture, cricothyrotomy and bougie-assisted cricothyrotomy, their implementation, teaching, advantages and disadvantages.