cricothyrotomy kits

[Chatterbox]

Can someone tell me exactly what makes up a cricothyrotomy kit please?

[Doc]

Emergency Cricothyrotomy

Here's what I use in the field.

1. Number 7 or 8 endotracheal tube that I cut down to a more usable size for this procedure. (Be careful not to damage the inflatable cuff or render it inoperable. Cutting the ET tube down helps prevent the tube from unnecessary movement once the procedure is complete. The "cap" of the ET Tube is reattached to the improvised section and can be accessed via the ambu bag.)

2. Number 11 surgical blade attached to a handle.

3. 10cc syringe. (To inflate the cuff of the ET Tube)

4. Tape. (To secure the tube)

This is to accomplish the procedure and maintain an airway.

Some folks make a horizontal incision. I make a vertical one out of respect for the anatomy in this area of the body.

Adjuncts to this procedure include an ambu bag and O2. Always check your work with a stethoscope over all fields of the lungs to insure proper placement of the ET Tube.

Disclaimer: Make sure that you are trained/certified to do this procedure before attempting to do one. It is a simple technique, but has catastrophic complications if not performed correctly. Check the laws pertaining to your location.

[Chatterbox]

Thanks.

[BP]

Doc,
I have found that a pair of sterile surgical scissors works very well. I agree with the vertical cut.
With the scissors, you can pinch the skin, cut vertically, then blunt dissect (horizontally with the scissors) through the CT membrane. I have found this to preserve the vascular and glandular structures better while providing less room for error in the (non-experienced) field medic with a scalpel. I have seen one case where if the closed head injury didn't kill the guy, then the poor cricothyrotomy did. Although most could have done better at 3 feet with a sword.
Any thoughts?

[Doc]

Originally posted by BP
Doc,
I have found that a pair of sterile surgical scissors works very well. I agree with the vertical cut.
With the scissors, you can pinch the skin, cut vertically, then blunt dissect (horizontally with the scissors) through the CT membrane. I have found this to preserve the vascular and glandular structures better while providing less room for error in the (non-experienced) field medic with a scalpel. I have seen one case where if the closed head injury didn't kill the guy, then the poor cricothyrotomy did. Although most could have done better at 3 feet with a sword.
Any thoughts?

It's a technique. As long as it works and does minimal harm to my buddy, I'm all for it.
DOL

[Medic_21]

Just to add to Doc42's list;

Try and get your hands on an "trach tube". They are specifically designed for crics.

If you don't have the money or resources to put together the proper kit, you can improvise,

-carpenters knife (the precision kind)
-alcohol swabs (for the blade)
-ballpoint pen body
-masking tape


This is obviously 2nd class next to the proper, but is useful as a "poor man's cric kit"

[DFC5343]

Atleast our "Doc's" are proficent.

[Medic_21]

When you don't have the prepared equipment on hand, let's see how proficient one is. People who aren't medically sound really shouldn't discuss medical issues.

[Doc]

Originally posted by Medic_21
When you don't have the prepared equipment on hand, let's see how proficient one is. People who aren't medically sound really shouldn't discuss medical issues.

Could you elaborate???

[Medic_21]

"Could you elaborate"

On what? The part where people who aren't trained in medicine staying out of medical conversations or using 2nd rate equipment when the 1st rate equipment isn't there for you?

[Doc]

Medic_21

You stated that for a field expedient cric to have a ballpoint pen body handy to serve as a means of getting air through.

Close off your nose and try breathing through only a ballpoint pen body in your mouth. It's not large enough. You'll run out of air.

Better try something else.

[WGMedic]

Hey guys, new to the area but thought you would get a kick out of this. In the system I work we cannot do surgical cric's - we can only do needle... in short, we shove a 10 gauge angio in that area... Hopefully soon we will be able to do the surgicals in the back of our rigs - God knows we have to soon...

Cheers,
Scott

[soup82]

First - check his watch and wallet - ascertain consciousness, if he's out, take em, I mean secure em. Take an iv infusion set. Cut the drip chamber in half - Locate the ct notch. Remove the cover from the spike. Draw your hand back as far as you can (think Pulp Fiction) and DRIVE that mofo through the skin and the ct cartalage/membrane. Calmly attach an ambu bag to the drip chamber that has been cut in half (nice fit hunh). Aerate that poor mistreated SOB. If he comes around - run like hell.

Next week, blindfolded cutdowns with a chainsaw

Question of the week - how many medics on the board besides me have ever seen Guinea Worm (dracunculiasis)? Pretty cool looking hunh.

Cheers,

P. LaRocque