1. Assess patient and make decision to perform emergency cricothyroidotomy. (ABC's, LLF, Failed attempts at all other airway management).
2. Assemble and check equipment (Scalpel #10 blade, ET tube, 10 cc syringe, tape, Curved Kelly hemostats/Trach Hook, gauze).
3. Prepare patient (Place patient in supine or semi-recumbent position and place neck in neutral position).
4. * Locate landmarks (palpate thyroid and cricoid cartilages, locate cricothyroid membrane).
5. Cleanse the incision site with alcohol or betadine.
6. Stabilize the thyroid cartilage using your non-dominant hand.
7. Make 1 inch, vertical incision over the cricothyroid membrane.
8. Visualize cricothyroid membrane.
9. Make ½ inch, horizontal incision to cut through the cricothyroid membrane.
10. Open incision with blunt dissection.
11. * Insert endotracheal tube into the incision, directing the tube distally down the trachea (no more than 3 - 4 inches).
12. Inflate balloon with 10cc's of air.
13. Ventilate patient with two breaths & check for proper placement (Auscultate epigastric area - If patient has epigastric sounds, remove and retry, observe for bilateral rise/fall of chest, misting or fogging in E.T. tube and auscultate for breath sounds bilaterally).
14. Lung sounds on right side only (deflate cuff, pull back ¼- ½ inch, re-inflate cuff, recheck placement.
15. Secure tube.
16. Apply dressing (petroleum gauze on insertion site, dry sterile dressing over petroleum gauze).
17. Reassess & monitor patient (if not breathing on own, 1 breath every 5 seconds, suction as necessary).
7th Edition•ISBN: 9780323087896 (1 more)Julie S Snyder, Linda Lilley, Shelly Collins 7th Edition•ISBN: 9780323402118Gary A. Thibodeau, Kevin T. Patton 12th Edition•ISBN: 9780134183268 (1 more)Rebecca J. Donatelle 1st Edition•ISBN: 9781260470772Paula Manuel Bostwick