Can you do a Cric?

It's #CritBits episode 11 and I'm talking about the importance of knowing how to perform a cricothyroidotomy if you give paralytic medications for rapid sequence intubation (RSI).
Although pushing paralytics aids in first pass success, failure to ventilate during subsequent attempts necessitates immediate surgical airway access. Don't depend on external help, stressing that emergency airway providers must be prepared to perform a cricothyroidotomy themselves to ensure patient safety during airway management in critical situations.
What do you think?

[@DSmith-xf5xi]

Love the videos. Anesthesia here. Paralytics or not - you've pushed induction drugs to render the patient unconscious and in many instances, apneic. Regardless of whether you had a drug (Suggamadex or alternative) to reverse the paralytic, you still would have wait for those other induction agents to wear off to have a spontaneously breathing patient. Paralytics only make everything easier (BMV, intubation). So love the message, but would suggest its "if you're intubating people, you need to know how to do a cric" not necessarily whether or not you push paralytics.

[@theicugeek997]

I agree 100%. I will add that you also probably shouldn't push paralytic unless you have and proficient with a videolaryngoscope and some form of supra glottic airway.

[@coldblue42]

It obviously depends on the scenario but some of our older docs who feel less comfortable with it, call anesthesia or ER to intubate our pts rather than risking it. Try and optimize the pt as much as possible before hand

[@minutemanmedic4143]

As a Paramedic it is mind boggling that an EM doctor wouldn’t know how to do this. If I didn’t know how to cric, I wouldn’t have passed Paramedic school.

[@positronisomer206]

They do know. Or theoretically should know.

[@minutemanmedic4143]

@@positronisomer206 that’s what I’m saying, I was under the impression that it was required for them to know