{"id":154,"date":"2015-12-07T17:14:08","date_gmt":"2015-12-07T17:14:08","guid":{"rendered":"http:\/\/brooksidepress.org\/surgery\/?page_id=154"},"modified":"2015-12-07T17:14:08","modified_gmt":"2015-12-07T17:14:08","slug":"3-5-surgical-airway","status":"publish","type":"page","link":"https:\/\/brooksidepress.org\/surgery\/?page_id=154","title":{"rendered":"3-5. SURGICAL AIRWAY"},"content":{"rendered":"<p>a. <strong>General<\/strong>. The primary indication to create a surgical airway is the need for an\u00a0airway for a patient who cannot be intubated.<\/p>\n<p>Cricothyrotomy, creation of a surgical\u00a0airway, is the incision through the skin and cricothyroid membrane to secure a patient\u00a0airway for emergency relief of upper airway obstruction. The word cricothyroidotomy is\u00a0another name for this surgery.<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/148115261\" width=\"500\" height=\"341\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>The two types of cricothyrotomy are needle cricothyrotomy\u00a0and surgical cricothyrotomy. The needle cricothyrotomy method is preferable\u00a0in an emergency situation for a child under 12 years of age, but is still very temporary.<\/p>\n<p>b. <strong>Procedure for Surgical Cricothyrotomy.<\/strong> Follow this procedure.<\/p>\n<p style=\"padding-left: 30px;\">(1) Identify the cricothyroid membrane. Do this in the same way as for\u00a0needle cricothyrotomy.<\/p>\n<p style=\"padding-left: 30px;\">(2) Prepare the skin over the membrane with povidone-iodine.<\/p>\n<p style=\"padding-left: 30px;\">(3) Puncture the cricothyroid membrane in this manner:<\/p>\n<p style=\"padding-left: 60px;\">(a) Make a vertical skin incision over the lower one-half of the\u00a0cricothyroid membrane.<\/p>\n<p style=\"padding-left: 60px;\">(b) Carefully incise through the membrane.<\/p>\n<p style=\"padding-left: 60px;\">(c) Insert the scalpel handle into the incision and rotate 90 degrees to\u00a0open the airway.<\/p>\n<p style=\"padding-left: 30px;\">(4) Insert the cannula or ET tube.<\/p>\n<p style=\"padding-left: 60px;\">(a) Keep your left hand on the larynx to stabilize the larynx.<\/p>\n<p style=\"padding-left: 60px;\">(b) Pick up the cannula in your dominant hand. Place the cannula\u00a0through the puncture hole, with the cannula tip pointing toward the patient&#8217;s feet.<\/p>\n<p style=\"padding-left: 60px;\">(c) Using controlled force, insert the cannula and advance it until the\u00a0flange is flush with the skin.<\/p>\n<p style=\"padding-left: 60px;\">(d) If you are using a cuffed tracheostomy tube, inflate the cuff.<\/p>\n<p style=\"padding-left: 30px;\">(5) Check for correct placement.<\/p>\n<p style=\"padding-left: 60px;\">(a) Listen and feel for air flow through the cannula.<\/p>\n<p style=\"padding-left: 60px;\">(b) Ventilate through the cannula. The patient&#8217;s chest should rise and\u00a0fall with each ventilation. The patient&#8217;s breath sounds should be audible on both sides\u00a0of his chest.<\/p>\n<p style=\"padding-left: 30px;\">(6) Secure the cannula with tape.<\/p>\n<p><em><strong>NOTE: Due to its potential hazards, cricothyrotomy should be performed ONLY by\u00a0personnel who have been thoroughly trained in this method and who have\u00a0been approved by their physician directors to use this method.<\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>a. General. The primary indication to create a surgical airway is the need for an\u00a0airway for a patient who cannot be intubated. Cricothyrotomy, creation of a surgical\u00a0airway, is the incision through the skin and cricothyroid membrane to secure a patient\u00a0airway for emergency relief of upper airway obstruction. The word cricothyroidotomy is\u00a0another name for this surgery. &hellip; <a href=\"https:\/\/brooksidepress.org\/surgery\/?page_id=154\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">3-5. SURGICAL AIRWAY<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":129,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-154","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/pages\/154","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=154"}],"version-history":[{"count":1,"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/pages\/154\/revisions"}],"predecessor-version":[{"id":155,"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/pages\/154\/revisions\/155"}],"up":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=\/wp\/v2\/pages\/129"}],"wp:attachment":[{"href":"https:\/\/brooksidepress.org\/surgery\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=154"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}