In airway management during cardiac arrest, when is cricothyrotomy indicated?

• A. Upon successful ventilation.
• B. As a routine initial step.
• C. When unable to ventilate by any other means.
• D. Only in non-emergency settings.

Answer: (C)

In cardiac arrest, the priority is to secure a patent airway and achieve effective ventilation quickly. You start with noninvasive maneuvers and devices (head-tilt/chin-lift or jaw-thrust, bag-valve-mask ventilation, then supraglottic airway or endotracheal tube if feasible). A cricothyrotomy is a rescue surgical airway that directly bypasses the upper airway by placing a tube through the cricothyroid membrane into the trachea. It is indicated only when you cannot ventilate by any other means—i.e., despite attempts with basic maneuvers and airway devices, adequate ventilation/oxygenation cannot be achieved. In the emergency, this is a time-critical last resort to restore ventilation. It is not used as a routine initial step or only in non-emergency settings.