Talk:Cricothyrotomy

Where

Blanket statements about illegality are meaningless. Do you have research to show it is illegal in every country, or by international treaty? —Preceding unsigned comment added by Ralmin (talk • contribs) 03:04, 9 November 2007 (UTC)

I am a doctor and as far as I know, in the countries I have worked in and are familiar with (Singapore, Australia), even if you are not a doctor, if the person in front of you appears certain to die if a certain procedure is not performed, you will not be liable for mistakes made in a genuine attempt to save the person's life. This is, of course, granted that there was no one else more competent to perform the procedure and that any delay in performing the procedure will result in certain death of the person. The keywords are "genuine attempt to save life" and "no other choice".

I suspect the statement about illegality is wrong but I would like to be proven otherwise. Alex.tan (talk) 12:20, 22 January 2009 (UTC)

Merger proposal

The merger proposal is on the other page at Talk:Crichothyrotomy. WhatamIdoing (talk) 18:41, 20 November 2007 (UTC)

• I have merged content to Cricothyrotomy. They are not two alternative spellings - "crichothyrotomy" is simply an error. Snalwibma 16:15, 30 November 2007 (UTC)

Incision Direction

I am not a doctor, but I noticed that the first step (in the summarized technique) is to make a 2 cm "horizontal" incision, yet the animated picture next to it seems to show a 2 cm "vertical" incision. Is this just medical nomenclature based on a surgeon's perspective? Perhaps the wording should say "in line with the trachea" or "perpendicular to the trachea", or have a note as to why the directions appear different. Tysior (talk) 15:07, 29 January 2009 (UTC)

I'm not a doctor either, ...The diagram appears to be inconsistent with the text: however, i've seen demonstrations of it both ways for example: transverse: (GRAPHIC) http://www.brooksidepress.org/Products/OperationalMedicine/DATA/operationalmed/Procedures/Cricothyroidotomy.htm and vertical: http://content.nejm.org/content/vol358/issue22/images/small/10f1.gif

It seems like most recent examples make at least the skin incision vertically, but note that there are two parts: opening the skin and then puncturing/cutting the membrane to open the trachea. we probably need a doctor familiar with the technique to explain it. Rmed (talk) 01:39, 4 July 2009 (UTC)

Ok i found some more information: from http://www.stbarnabashospital.org/training/surgery/Lectures/cricothyroidotomy.ppt

"""Discussion, Vertical or Horizontal incision? Vertical is best for emergencies, you will expose the membrane guaranteed. Vertical does not heal well, there may be a scar and some internal scaring/fibroids. You have to be alive to be inconvenienced by the scar."""

It goes on to say that the membrane itself has to be cut transversely (horizontally) Rmed (talk) 02:12, 4 July 2009 (UTC)

I am an senior Emergency Physician so feel able to explain more about this issue. Most physicians would recommend an initial vertical incision through skin, followed by a transverse incision through the cricothyroid membrane. As stated above, a vertical skin incision will expose the membrane more reliably than a transverse skin incision. Another important advantage is that important arteries that run parallel and close to the trachea and larynx are less likely to be cut with a vertical incision. Hope I've made this entry correctly; I'm new here! —Preceding unsigned comment added by Mccarcass (talk • contribs) 21:57, 27 July 2010 (UTC)

Restoring the section on Cricothyrotomy in popular media

This section was present until February 4th, 2010. It was removed with the following explanation: “rm entire section, sensationalized tv shows will obviously include emergency medical procedures. the crike is not the focus of any of these references.” The complaint here is clearly that the references lack notability because crike is not their focus. But surely, this is too stringent a standard for notability. Many topics covered in Wikipedia have many levels of significance, i.e., though they are primarily about A, they nevertheless have a secondary relevance for B, and tertiary for C, etc. (I hope this is obvious enough and that no one will make me go dig up actual examples). So what should be the actual criterion of notability? This question apparently arises frequently enough that it was in fact discussed in the essay “Wikipedia:‘In popular culture’ content.” (We all agree that essays like this are not laws; nevertheless, they often do make sense.) About the topic of notability of references in popular culture sections, the essay says the following:

In determining whether a reference is notable enough for inclusion, one helpful test can be to look at whether a person who is familiar with the topic only through the reference in question has the potential to learn something meaningful about the topic from that work alone. For example, if a movie or a television series has been filmed in a town, the viewer is seeing a concrete representation of what the town actually looks like at street level; but if the town is merely mentioned in a single line of dialogue, the viewer hasn't learned anything except that the place exists.

Now, medical TV shows like Grey's Anatomy and ER do strive for quite a bit of realism in depicting medical treatment—or so I'm told by friends in the medical profession (if anyone insists on actual reputable sources for this, I'm pretty sure I would be able to find them). Therefore what the viewer learns about crike by watching the relevant episodes is not negligible. Viewers learn roughly what it looks like when it's done, under what circumstances it is done, by whom it's done, what it accomplishes, etc. Thus it seems to me that notability criterion is amply satisfied.

Let me note also that tons of Wikipedia articles have these “In popular culture” sections; as the essay “Wikipedia:‘In popular culture’ content” explains, even if one objects to blind lists of pop-culture references, such lists can grow to include more content, having to do with cultural analysis and the like, and thereby “positively distinguish Wikipedia from more traditional encyclopedias.” Even in the worst case scenario of blind lists, all that the essay says is that

When poorly written or poorly maintained, however, these sections can devolve into indiscriminate collections of trivia or cruft. They should be carefully maintained, as they may attract non-notable entries, especially if they are in list format.

In particular, there is no recommendation for an outright removal.

Thus I'm restoring the section. (I also edited somewhat the third reference to Grey's Anatomy, since it didn't quite make sense the way it was written.) Reuqr (talk) 07:40, 8 July 2010 (UTC)

I'm wondering if the reference to that "M A S H" episode is in the wrong article. When Pierce talked Father Mulcahy thru that procedure, I'm pretty sure it was referred to as a tracheotomy. So did the writers call the procedure by the wrong name, or is it mentioned in the wrong article? 12.31.187.178 (talk) 17:38, 1 July 2019 (UTC)

Adequacy of ventilation and CO2 elimination with cricothyroidotomy

The last two sentences of the summary are incorrect. It is quite possible to ventilate and eliminate CO2 adequately through a cricothyroidotomy.

Cricothyroidotomy can be performed in two distinct ways: using a needle and fine bore cannula (needle cricothyroidotomy, not described in this article), or using a scalpel and a specially designed tracheal tube (surgical cricothyroidotomy). Surgical cricothyroidotomy uses a 6mm tube which easily allows enough gas to pass back and forth to ventilate the patient without a rise in CO2. Needle cricothyroidotomy uses a cannula that is too fine to allow much gas to escape from the lungs. For this reason it cannot be used for more than an hour without substantial CO2 accumulation in the body. Mccarcass (talk) 22:10, 27 July 2010 (UTC)

Naming

Considering its latin origin I am just curious, shouldnt the procedure be called cricthyrostomy with an s in front of tomy? AriaNo11 (talk) 18:02, 25 September 2010 (UTC)

Restoring the section on Cricothyrotomy in popular media, again

The section was removed again, without really addressing the argument for keeping it that I provided a few section above on this talk page.

This time, the explanation for removing it was “medical procedures are often performed in medical fiction.” I suppose the argument, spelled out in a little more detail, would be this: there are many medically-oriented works of fiction, which collectively mention a huge number of medical procedures. It is absurd (so the argument goes) to try to catalog, here on Wikipedia, the appearance of every single medical procedure done on every medical TV show or film or book in history; therefore, one should not mention any appearances of medical procedures in any works of popular culture, if the only reason to do so is to catalog them.

If this is the argument for not having the "in popular culture" section in the cricothyrotomy article, then I disagree with it. Let me, for the sake of argument, grant that we should not “try to catalog the appearance of every single medical procedure done on every medical TV show” (it is in fact not clear to me that even this much is correct; I certainly will not try to do it, but if someone else decides to do it, that would be fine by me). Even granting this much, however, all that follows is that there are some procedures that should not be cataloged; it does not follow that none should. I (of course) don't have a definitive answer as to what criterion should be used to decide which procedures should and which should not have an "in popular culture" section, but one criterion might be how interested the article contributors are in having such a section (consensus building, remember?) For example: on the appendectomy page (and its history), I see that no one has as yet attempted to add an "in popular culture" section, whereas a lot of people have contributed to the "in popular culture" section for cricothyrotomy. I don't know precisely (though I have some guesses) what accounts for the difference, but there clearly is some difference. Thus, keeping in mind that (as I mentioned on this page the first time around I restored the "in popular culture" section) lists of pop-culture references can grow to include more content, having to do with cultural analysis and the like, and keeping in mind WP:PRESERVE, I think the "in popular culture" section of this article should be kept. Reuqr (talk) 22:12, 26 February 2011 (UTC)

This is too much for me to read. Can you provide more succinct version? Doctorfluffy (robe and wizard hat) 22:25, 26 February 2011 (UTC)

O.K., here is the "short version." Unlike in the case of articles on some other medical procedures (say, appendectomy), the editors of this article have historically been quite willing to contribute to an "in popular culture" section. At the same time, such sections are not discouraged by Wikipedia; indeed, they may “positively distinguish Wikipedia from more traditional encyclopedias.” Therefore, absent convincing arguments for removing it, the section should be kept. You did provide some arguments for removing it, but I don't think they are strong enough to justify removal; for details, see the “long version.” Reuqr (talk) 18:15, 27 February 2011 (UTC)

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