HWN Suggests

The Sphincter Series: Emergent Cricothyrotomy

The Scalpel-Finger-Tube Technique: The authors advocated for the use of a “little finger” as the dilator to confirm placement because it was readily available in a time-critical situation and could simultaneously confirm placement and dilate the wound to a sufficient size to allow passage of the tube. They also cited tactility and sensation of the finger as an advantage to this method, and critical in field situations, when in darkness or patient entrapment scenarios direct visualization is difficult or impossible.

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 Surgical Cricothyroidotomy

Numerous techniques have been described, my preferred approach is the ‘knife-finger-bougie’ approach...

Articles of Interest

Why You Need a FONA Kit

The Scalpel Finger Bougie (SFB) technique did away with the old emergency cricothyrotomy kits, and while the old kits should remain in the past, maybe it’s time we rethink the value of the kit when it comes to eFONA. A kit still has many advantages. It can improve your efficiency, save valuable time and reduce error when the stakes are high and time is short. So let’s take a moment to consider the advantages of a kit designed for the current age of eFONA.

Keychain Emergency Airway Device (Video)

Health professionals who know how to perform cricothyroidotomy to obtain an emergency airway in someone who is obstructing can appreciate a nifty keychain device called LifeStat.

Tips and Tricks for Performing Cricothyrotomy

Despite advanced airway management options like mask ventilation supraglottic airways, there is still a role for cricothyrotomy in the ED. Here are some tips on when to use cricothyrotomy and tricks on performing the surgery.

Cricothyrotomy Needle

Use the largest IV catheter possible, such as a size 10 or 14 gauge in the adult. For a child choose a smaller catheter such as an 18 or 16 gauge.

Cricothyrotomy – Cut to Air: Emergency Surgical Airway

In appropriate circumstances (prophylactic cricothyroidotomy) has numerous advantages, not least the potential to secure and check the ‘rescue airway' in a calm and unhurried manner, without hypoxia, before an emergency arises...

Ditch the Needle – Teach the Knife!

Bougie-assisted surgical cricothyroidomty is the recommended technique in can’t intubate, can’t ventilate situation. Why? Because you can do it without any formal training, maybe youtube training to accomplish the procedure.

Ditch the Needle, Teach the Knife Part II

Because of its rare occurrence, most anesthesia personal have no real-life experience with this technique. Hence we should better prepare ourselves in case when we need it.

Don’t Be afraid To Use Percutaneous Jet Ventilation In An Emergency

Needle cricothyrotomy or percutaneous transtracheal jet ventilation (PCJV) can truly be a life saving procedure. It is a fast, effective way of providing oxygen to a patient with an obstructed airway who does not respond to more conventional means of opening the airway. The “can’t intubate-can’t ventilate” scenario is a good example.

Emergency cricothyrotomy – a systematic review

The large majority of the studies were too small to demonstrate statistically significant differences, and the limited available evidence was of low or very low quality. That none of the techniques in these studies demonstrated better results than the others does not necessarily indicate that each is equally good, and these conclusions will likely change as new evidence becomes available.

Equipment and strategies for emergency tracheal access in the adult patient

To prevent hypoxic brain damage and death in a ‘cannot intubate, cannot oxygenate’ situation, emergency percutaneous airway access must be performed immediately.

Mind Blowing Cricothyrotomy Video

My friend and former resident, performs a life-saving cricothyrotomy on a post-arrest patient.

Resources

ClinicalMonster.com

If right hand dominant stand on patients right side...

Quicktrach

With the Quicktrach I and II we offer two sets for percutaneous cricothyrotomy for adults, children and newborn by needle incision. A quick airway access is made possible with a via one-step procedure. An incision by scalpel isn't necessary. The sterile sets are pre-assembled and immediately ready for use.