Difference between revisions of "Cricothyrotomy Surgical"

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(EQUIPMENT:)
(PROCEDURE: (refer to illustrations):)
Line 21: Line 21:
 
====PROCEDURE: (refer to illustrations):====
 
====PROCEDURE: (refer to illustrations):====
 
[[File:Quiktrach1.jpg|left|200px|]]
 
[[File:Quiktrach1.jpg|left|200px|]]
[[File:SurgCrich1.jpg|200px|thumb|left|]]
 
 
* Place the patient in a supine position with the neck in a neutral position.
 
* Place the patient in a supine position with the neck in a neutral position.
 
* Palpate the thyroid notch, cricothyroid membrane, and the sternal notch for orientation. Gather equipment.
 
* Palpate the thyroid notch, cricothyroid membrane, and the sternal notch for orientation. Gather equipment.
 
* Prepare site with Antiseptic swabs.
 
* Prepare site with Antiseptic swabs.
 
* Stabilize the thyroid cartilage with thumb and 3rd finger of hand. Stretch skin taut.
 
* Stabilize the thyroid cartilage with thumb and 3rd finger of hand. Stretch skin taut.
* Make a superficial transverse skin incision over the cricothyroid membrane.  Carefully puncture through the membrane and maintain site with tip of gloved index finger.
+
* Puncture the thyroid cartilage with the device.
[[File:SurgCrich2.jpg|200px|thumb|left|]]
+
* Insert the Quiktrach into the trachea.
* Insert the scalpel handle into the incision and rotate 90 degrees to open airway OR insert hemostats to enlarge opening for passage of tube.
+
* Remove the stopper from the Quiktrach device.
* Insert cuffed endotracheal tube into the cricothyroid membrane incision directing the tube distally into the trachea.
+
* Remove the metal needle and advance cannula.
* Inflate the cuff and ventilate the patient with BVM.
+
* Ventilate the patient with BVM.
 
* Observe breath sounds and auscultate the chest for adequate ventilation.
 
* Observe breath sounds and auscultate the chest for adequate ventilation.
* Secure the endotracheal tube.
+
* Secure the Quiktrach device.
 
* Continue to ventilate and observe chest rise.
 
* Continue to ventilate and observe chest rise.
  
 
[[Category:Procedure Guidelines|0910]]
 
[[Category:Procedure Guidelines|0910]]

Revision as of 11:15, 16 September 2019

Procedure Guidelines 9.10

CRICOTHYROTOMY (SURGICAL)

INDICATIONS:

  • If unable to ventilate and airway not patent, perform Cricothyrotomy, as listed on line 5, page 2-7 in the Practice Parameters.
  • When an airway is needed and intubation is unsuccessful.


CONTRAINDICATIONS:

  • Children under 12 years old.
  • Known bleeding disorder and/or anticoagulant therapy.
  • Unable to locate landmarks.


EQUIPMENT:

Quiktrach.jpg
  • Quiktrach kit (Adult or Child size)

PROCEDURE: (refer to illustrations):

Quiktrach1.jpg
  • Place the patient in a supine position with the neck in a neutral position.
  • Palpate the thyroid notch, cricothyroid membrane, and the sternal notch for orientation. Gather equipment.
  • Prepare site with Antiseptic swabs.
  • Stabilize the thyroid cartilage with thumb and 3rd finger of hand. Stretch skin taut.
  • Puncture the thyroid cartilage with the device.
  • Insert the Quiktrach into the trachea.
  • Remove the stopper from the Quiktrach device.
  • Remove the metal needle and advance cannula.
  • Ventilate the patient with BVM.
  • Observe breath sounds and auscultate the chest for adequate ventilation.
  • Secure the Quiktrach device.
  • Continue to ventilate and observe chest rise.