In an uncommon act of medical intervention outside a hospital, Dr. Manoop B, performed a surgical cricothyrotomy on a roadside with the help of doctor couple, Dr. Thomas Peter, and Dr. Dhidiya K Thomas at Udayamperoor in Ernakulam district, Kerala after a roadside traffic collision left a man in life-threatening respiratory distress. The intervention prevented imminent death from suffocation and helped the patient reach definitive care in time.
Around 8:30 pm on December 21, 2025, a violent collision between a scooter and a motorcycle at Valiyakulam, left three people injured Vipin, Manu and Linu. Emergency responders had not yet arrived when the doctors who were traveling separately stopped at the scene after noticing damage and bystanders gathered around the victims. Initially, Dr Manoop B, Assistant Professor of Cardiothoracic Surgery at Government Medical College, Kottayam reached the spot and checked on the patients while the doctor couple who were Resident Medical Officers from the Emergency Department of Indira Gandhi Cooperative Hospital, Kadavanthra also arrived.
Upon assessing the scene:
Two of the injured had non-critical injuries but one victim, Linu, was unconscious and struggling to breathe. Upon opening the helmet carefully after stabilising the neck, they observed that airway was obstructed with blood, soil, and facial trauma.
The doctors quickly recognized that airway compromise posed an immediate threat of respiratory arrest, which can lead to brain damage or death within minutes if not relieved.
Because standard airway management through the mouth or nose (intubation) was not possible due to severe facial injuries, Dr, Manoop B decided to perform a surgical cricothyrotomy — a procedure that creates an airway directly through the neck below the voice box (larynx). This procedure is typically done in controlled hospital settings when less invasive methods fail or are impossible.
With no medical instruments available, they improvised:
A razor blade was used to make a 3cm incision through skin and membrane in the neck over the cricothyroid area.
A paper straw was initially inserted, but when it began soaking up the blood and resulted in further obstruction, a plastic juice straw, was inserted into the opening to act as a temporary airway conduit to allow air to flow into the lungs.
Police on site helped clear the area and asked bystanders to illuminate the scene with mobile phone flashlights. Local residents also cooperated by providing materials and ensuring no videos were taken, prioritizing patient privacy and safety.
Once the improvised airway was established and Linu began breathing more effectively, the first ambulance arrived and transported him to Welcare Hospital, Vyttila. During the ambulance transfer, Dr Manoop continued to blow air into the straw until medical staff could take over.
At the hospital, Linu experienced a cardiac arrest but was successfully revived by the emergency team, including CPR and further interventions. At the time of reporting, his condition was critical but stable.
A cricothyrotomy is a life-saving emergency airway procedure used when the upper airway is blocked and conventional intubation is not possible. It involves creating a direct opening in the neck between the thyroid cartilage and cricoid cartilage to insert a tube or airway device that allows ventilation. This technique is most often practiced in emergency departments, operating rooms, or during advanced trauma care but can be crucial in pre-hospital care when time is limited.
In trauma scenarios, immediate airway control is a priority because oxygen deprivation — even for a few minutes — can result in irreversible brain injury or death.
Their actions have been widely praised by medical associations like IMA and public figures alike, with leaders acknowledging the quick decision-making and medical skill that intervened at a critical moment.
(Rh/TL)
