Surgical Airways Flashcards
What is a cricothrotomy
Surgical opening into the trachea through the cricothyroid membrane and placing a cuffed tube
What are the indications for a cric
Pt must not be able to be ventilated by any other means
What are the four dimensions of difficult airway management? (SMART)
Surgery hx (specifically on the neck)
Mass
Access/anatomy
Radiation
Trauma/tumor
What are the contraindications of a cric
-absence of indications
-<10 years of age
What are relative contraindications for a cric
Pre-existing laryngeal or tracheal pathology
Tumor, infections, abscess
Hematoma or impossible to do due to anatomy
Coagulpathy and thrombocytes therapy
What are complications of a cric
Hemorrhage
Laryngeal Injury
Esophageal Damage
Aspiration
Pneumo
S/c emphysema
Barotrauma
Infection
Voice changes
DEATH
What are the three types of cricothyrotomy
-open
-precutaneous transtracheal ventilation
Bougie assisted
What are the anatomical landmarks for the cricothyroid membrane?
Laryngeal prominence
1 fingerbreadth inferior
-superior cricoid ring
How to preform a cric
Prepare
Landmark
Clean site
Cut a 2cm hole in the skin and re identify the membrane
Spread the membrane
Insert tube
Confirm and secure
How to preform a needle cric
Clean and landmark site
Insert 12-16 gauge needle
Advance the catheter
Remove the needle after placement confirmation
Do not let go of the catheter
How to use a BVM with a needle cric
3 ETT adapter - angiocath
#7.5/8 ETT adapter
Advantages of a needle cric
-speed
-simple
-less bleeding
-small space
Complications of a needle cric
-Barotrauma
-s/c emphysema
-only temporary
-no airway protection
-obstruction (cannot suction)
-catheter kinking
-esophageal puncture
-mucosal damage
