Cricothyrotomy

21 Aug

Procedure Quick Review

  1. Prep (hopefully you were planning ahead, have your equipment, and maybe some betadine to squirt on the neck)
  2. Vertical incision first (avoid vessels, and won’t have to re-cut if at the wrong spot)
  3. Horizontal stab incision through cricothyroid membrane
  4. Put something in the hole (Bougie, dilator, hook, finger, something)
  5. Trach or 6-0 ETT (for the avg. adult) into the trachea
  6. Bag/ventilate

 

Interesting numbers:

Study of 102 anesthesiologists practicing crics on a mannequin, 

  • 94% of ’em could do a cric in <40 sec by the fourth attempt
  • 96% of ’em could do a cric in <40 sec by the fifth attempt

 

(take home: practice at least 4-5 times)

Study of 21 residents/students

  • median Time to successful cric with standard technique: 149 seconds (interquartile range = 111-201) 
  • median Time to successful cric with Bougie-assist technique: 67 seconds (interquartile range  = 55-82) 
  • (p = 0.002)

(i love the bougie)

 

Needle cric jury-rigged ambu-bag adaptor:

  • 14 G needle cric
  • 3ml syringe barrel 
  • 7-0 ETT adapter (pull off the back of the ETT, put into top of syringe where the barrel was)
  • bag away

 

References: http://crashingpatient.com/resuscitation/airway/cricothyrotomy.htm; anesthesia article; bougie-cric article; needle-cric; picture

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One Response to “Cricothyrotomy”

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  1. improvised cric tips for nightmare airways | DAILYEM - October 1, 2013

    […] improvised connector system using 3cc syringe & 7-0 ETT connector to ambu-bag (see previous post… […]

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