Groundbreaking study reveals new formula to improve emergency airway management for Anaesthetists

Anaesthetists have undertaken the largest study of its kind into the cricothyroid membrane (CTM) to improve accuracy and safety in the management of a patient’s airway.

Carried out by University Hospitals Coventry and Warwickshire (UHCW) NHS Trust between October 2018 and February 2022, the research involved more than 2,500 adults.

The cricothyroid membrane (CTM) is a part of your throat anaesthetists need to know about when they have to help someone breathe in an emergency. Accurate identification of the CTM before anaesthesia is advised, with ultrasound being a reliable method.

However, ultrasound requires training and equipment, so investigators used this study to help propose a special formula to predict the depth of the CTM, based on things like a person's body size and other measurements.

UHCW Consultant Anaesthetist Dr Umair Ansari, first author of the study and an Honorary Lecturer at Warwick Medical School, said: “The findings are invaluable for doctors. Knowing the depth of the CTM can help medical professionals plan for emergencies more effectively.

“The model created by researchers is highly accurate in predicting the depth of the CTM, which means doctors can be extra cautious in certain patient populations.

“This predictive capability is especially important in situations where intubation or oxygenation may not be possible and emergency front of neck access (eFONA) is required.”

The study found that things like sex, body mass index (BMI), neck size and how easy it is to feel the CTM are important for predicting its depth.

The formula can help doctors plan better in the event of an emergency. Researchers also found women tend to have a deeper CTM for a given neck size compared to men.

However, the study didn't include children or pregnant women and needs more testing before it can be used more widely.

Chief Medical Officer Jonathan Young added: “By providing a reliable predictive formula, UHCW is helping doctors worldwide prepare for emergencies more effectively, ultimately saving lives and enhancing patient outcomes.

“I am very proud to see such amazing research being carried out at UHCW, demonstrating our commitment to advancing medical knowledge.”

The Trust worked in collaboration with a Medical Statistician from Warwick Medical School and a group of Warwick Medical Students who helped with data collection. UHCW Anaesthesia Consultant, Professor Cyprian Mendonca, was the Principle Investigator.