Actual Emergency Cricothyrotomy video
The video footage is attributed to Dr Peter Rhee a trauma surgeon in USA.
There are some excellent learning points to take out of this footage.
- Whenever you see the intubator squinting, that is not a good sign. It means they are having trouble visualising landmarks. Offer to help improve view with simple techniques like jaw thrust, pulling the lip or corner of mouth , external laryngeal manipulation, removal of cricoid pressure if it was applied.
- Notice the vertical incision. Very clever as it produces the least amount of bleeding and allows the operator to extend the incision quickly if not in right location.
- What, no scalpel bougie cric technique, you cry! More like Scalpel Finger technique but be careful with the blade as you see it comes very close to cutting the finger of the operator.
- You need something to replace your finger and here they use a Kelly Clamp . A bougie is fine but does not dilate the wound as much as a clamp/forceps
- Notice the use of the tracheal hook. very handy to open the wound further and pull the thyroid cartilage out of the way. You can make your own with a 21 g needle bent into hook shape and attached to a syringe ( Luer lock secure connection!)