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Unformatted text preview: EMERGENCY CRICOTHYROIDOTOMY Vic Vernenkar, D.O. Vic Department of Surgery St. Barnabas Hospital EMERGENCY CRICOTHYROIDOTOMY Outline: I. II. III. IV. V. VI. VII. VIII. Indications for surgical airway placement Contraindications Complications Anatomy of the Trachea and landmarks Tools Required Performing the Procedure Securing the airway Credits EMERGENCY CRICOTHYROIDOTOMY DEFINITION An emergency surgical procedure where An an incision is made through the skin and cricothyroid membrane which allows for the placement of an endotracheal tube into the trachea when airway control is not possible by other methods. not INDICATIONS Obstructed Airway - obstructions within the Obstructed airway will usually prevent the passage of an endotracheal tube or prevent the establishment of a patent airway. Therefore, a surgical airway distal to the obstruction is required. obstruction INDICATIONS Congenital deformities of the oropharynx or Congenital nasopharynx which inhibit or prevent nasotracheal or orotracheal intubation nasotracheal Trauma to the head or neck which would Trauma preclude the use of an ambu-bag, oropharyngeal airway, nasopharyngeal airway, or endotracheal tube insertion airway, INDICATIONS Cervical Spine fractures, or highly suspect Cervical fractures in a patient who requires an airway but whom nasotracheal intubation is contraindicated. Examples include: Examples Nasal bone fractures Cribiform fractures The healthcare provider is unable to establish an The airway by any other means and this is the “last airway last resort.” resort ADVANTAGES OF EMERGENCY CRICOTHYROIDOTOMY Provides a definitive airway for ventilating Provides the patient the Can be performed quickly and has few Can complications associated with the procedure complications ADVANTAGES OF EMERGENCY CRICOTHYROIDOTOMY For an emergency cricothyroidotomy the laryngeal prominence and cricoid cartilages are palpated and entry is made through the median cricothyroid ligament. ligament. This procedure is p...
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