Cricothyroidotomy, tracheostomy pearls from time spent in Richard Levitan's Airway Course Cadaver Lab: highly recommend the course!!!
Storified by Yen Chow · Sat, Jan 26 2013 23:09:55
http://vimeo.com/19132289 by @emcrit is AWESOME open cric sim/tutorial #ProcCric story "Scalpel Bougie Open Cric ..." http://sfy.co/aDOL
“RT: S: Surgical airway - needle cric, open cric/trach (scalpel-bougie-#6ETT) #ProcAWchklst #ProcCric”
“RT: Worked well in a cadaver that was +++++++BMI, very thick short neck #ProcCric”
#ProcCric also, this is the only airway procedure where neck hyperextension if not contraindicated helps
#ProcCric approach same side always in practice & battle: eg left hand palm cups chin, hold thyroid sides to find middle + landmark
#ProcCric left hand palm on chin steadies this hand
#ProcCric left hand thumb and middle locate thyd cart, left index landmarks, palpates if dissect and tracks scalpel hole so not lose it
RT:Always stay midline, if can’t feel anatomy, start cutting vertical incision, once thru skin as you dissect down, will feel anat #ProcCric
“RT: Like @EMCrit said, it is blind and bloody, all by feel, always keep instrument or your finger in cric hole you make #ProcCric”
Best technic was scalpel cut to air, finger in hole, put blade butt handle into hole to enlarge, slide bougie in and railroad ETT #ProcCric
@TBayEDguy thx. I’d leave finger in hole and try to slide bougie down along finger into trachea
@rfdsdoc hi, I expted and found scalpel blade did not make hole big enough for tube to slide over bougie, butt end of scalpel rotated worked
@rfdsdoc can slide bougie in over butt scalpel “dilator”, key was have finger or instrument always replace each other in hole so not lose it
@TBayEDguy true but I worry about that blade pointing up. once bougie dont hesitate to extend skin incision to pass tube
@rfdsdoc very true (esp in battle)
@rfdsdoc I see, good idea, insert bougie, then cut or dilate up cricothyroid membrane so tube can go in, thanks #ProcCric
#ProcCric note that you cannot cut the thyd cart as it is too hard
#ProcCric scalpel bougie open cric technique also worked at tracheal site in cadaver lab
