Download - Needle Cricothyroidotomy 2 - Hatem Alsrour
DEFINITION
• Needle Cricothyroidotomy - the introduction of an over-the-needle catheter device into the cricothyroid membrane to provide a temporary airway and oxygenation
OBJECTIVESAt the completion of this lecture the participant will be able to:
• State the indications for needle cricothyroidotomy
• Identify the equipment necessary to perform needle cricothyroidotomy
• Identify the landmarks of the cricothyroid membrane
-Discuss the potential complications of needle cricothyroidotomy
-Successfully perform needle cricothyroidotomy on a manikin
INDICATIONS
• Unconscious patient with a complete airway obstruction unrelieved by all other means appropriate to the situation
• BASE STATION ORDER
CAUSES OF AIRWAY OBSTRUCTION
– foreign body aspiration
– severe facial trauma
– infections
– swelling of the airway
– external swelling from injury
CRICOTHYROID MEMBRANE
• Is located between the thyroid and cricoid cartilage on the anterior neck
Cricothyroid Membrane
LANDMARKSLocate the superior aspect of the thyroid cartilage (prominence on the anterior neck)
Follow down midline to the indentation of the cricothyroid membrane
• The carotid arteries and jugular veins
• Additional blood vessels that feed into the thyroid gland
COMPLICATIONS• Penetration of adjacent structures
(esophagus)
• Subcutaneous emphysema• Swelling• Severe bleeding• Damage to the larynx• Injury to the thyroid and parathyroid
glands
EQUIPMENT
• Personal protective equipment
• Emergency Transtracheal Airway Catheter
• ENK Flow Modulator
• 10 cc syringe
• Alcohol prep
• 02 tank capable of delivering 30-60 psi
• Cloth or silk tape
EQUIPMENT (con’t)
• Emergency Transtracheal Airway Catheter– The ribbing on the
catheter keeps it from collapsing or kinking
• Connect to 15 L of 02 (1)
(1)
(2)
(3)• Covering and
uncovering the holes allows for oxygen movement in and out of the lungs (2)
• Medication can be administered through the port into the trachea (3)
• The needle and modulator will come prepackaged
• Needle cricothyrotomy is recommended when unable
• to oxygenate/ventilate children < 12 years of age
PROCEDURE
• Once your equipment is assembled, position the patient’s head
• If trauma - maintain the head in neutral position
• Stabilize the larynx by holding the cartilage between your fingers
• Direct the needle at a 90o angle to the patient
• Slowly advance the needle 1/2” - 3/4” with plastic catheter
• Assess the patient’s ABCs– do not expect to see significant rise and fall
of the chest wall
– if the patient begins spontaneous breathing, time your oxygenation with inhalation
– monitor patient’s color and heart rate
– if available, pulse oximeter may be helpful
– don’t forget COMPRESSIONS, if pulse is absent