Anatomic landmarks for needle cricothyroidotomy

(A) Cartilaginous skeleton of the extrathoracic airway. With older children and adolescents, the laryngeal prominence at the superior border of the thyroid cartilage can usually be palpated. The thyroid cartilage is followed inferiorly to locate the cricothyroid membrane.
(B) With infants and younger children, the laryngeal prominence is not developed. The rings of the tracheal cartilage are followed superiorly to locate the prominence of the cricoid cartilage. The cricothyroid membrane is just superior to the cricoid cartilage.
(C) A midline approach will avoid the normal position of the cricothyroid artery.