EMS A to Z: Case Series – Cricothyrotomy

Show Notes:

From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn

Indications:

Cricothyrotomy is indicated in the “can’t oxygenate, can’t ventilate” scenario

Conditions that may cause this scenario may include:

Airway obstruction (foreign body)

Facial trauma

Airway edema

Head/neck malignancy

Difficult airway anatomy

Equipment:

A commercial kit

Individual components

ETT (size 6) or tracheostomy tube

Scalpel

Bougie / forceps

Securing device / tape

Procedure:

Palpate cricothyroid membrane

Vertical incision through the skin

Vertical, followed by horizontal incision through the cricothyroid membrane

Insert digit, bougie, or forceps into the trachea

Insert ETT or tracheostomy tube

Inflate balloon

Confirm placement with auscultation, ETCO2

Ventilate

Contraindications:

Pediatric patients