Needle Cricothyrotomy

Circumstances rarely are such where we must perform a surgical airway emergently. When we do, it is always for the same indication: you have a patient that you can’t intubate AND can’t oxygenate. In most cases where a surgical airway is required, a traditional open or Seldinger technique is preferred.

In children, however, these approaches are contraindicated (most authors describe age less than 10 or so as the cut-off). Thus, the needle cricothyrotomy is a procedure that we must be prepared to perform as emergency providers as this can be done in pediatric patients. As such, it is critical that we rehearse the steps and are familiar with the contents of our kit.

The attached videos will take you through the procedure of percutaneous needle airway management. The videos will also describe our kit in detail. The kit is “home-made” by us and includes many component parts. Pay specific attention to when to use what combination of materials and to age specific flow rates.

Procedural Slide Set

First Person Video


  1. Walls, R., & Murphy, M. (2012) Manual of Emergency Airway Management, 4th edition.
  2. Roberts, J., & Hedges, J. (2003) Clinical Procedures in Emergency Medicine, 4th edition.
  3. Marx, J., Hockberger, R., & Walls, R. Rosen's Emergency Medicine - Concepts and Clinical Practice, 8th ed.