Procedure - Cricothyrotomy

Question 1

Surgical cricothyrotomy is contraindicated in kids younger than what?

Answer 1

12

Younger than 12 warrants needle cricothyrotomy.

Question 2

What is the basic process of cricothyrotomy?

Answer 2

Scalpel finger scalpel bougie ETT

You cut through the soft tissue, feel for the thyroid and cricoid cartilage, cut through the membrane, insert the bougie, and then pass the ETT in.

Question 3

What is the needle method for cricothyrotomy?

Answer 3

Grab a syringe with large bore needle, fill it half full of saline. Inject down toward where you think the membrane is at an angle pointing downward. Pull back on the plunger. When you see bubbles, you’re in the trachea. You can then pass a wire through the needle and guide an ETT over.

Question 4

Review the steps for needle cricothyrotomy.

Answer 4

• Stick a 12- or 14-gauge needle in the cricothyroid membrane.
• Use a syringe to pull back while entering slowly. This will tell you when you are in the lumen of the trachea.
• When you get air entry into the syringe, advance the catheter fully and then retract the needle.
• Ventilate with a machine that can do at least 50 psi.

Question 5

Needle cricothyrotomy provides ____________ but not ______________.

Answer 5

oxygenation; ventilation

Question 6

What tube size do you need for a cricothyrotomy?

Answer 6

Cuffed ETT 6 or smaller

Or a tracheostomy tube 4.

Question 7

After you have incised the cricothyroid membrane, you should stabilize the _______________.

Answer 7

trachea with a tracheal hook

Question 8

What tool allows you to open the incision in the cricothyroid membrane to allow for insertion of the tube?

Answer 8

The Trousseau dilator

Question 9

What size ETT cap fits on an angiocath to bag for a needle crich?

Answer 9

3-0