Scalpel-finger-bougie cricothyrotomy: Step 2: Incise the skin vertically, repalpate the cricothyroid membrane, then incise the cricothyroid membrane horizontally

(A) The initial incision for the scalpel-finger-bougie cricothyrotomy technique is a 5 to 10 cm vertical incision crossing the middle of the cricothyroid membrane.

(B) The index finger is inserted into the incision to dissect bluntly to the cricothyroid membrane. A rigid cartilaginous structure surrounding the finger should be palpated. This step is crucial for identifying anatomic landmarks, especially in patients with obesity, beards, substantial bleeding, or distorted neck anatomy (eg, abscess, mass).