This is the needle cricothyrotomy skill.
The necessary equipment for this skill
is an oxygen source
a BVM
a large bore IV catheter
a syringe
a three millimeter ET adapter
solution to cleans the site
gauze
tape
and a sharps container
additional ventilation equipment for this skill
may include a jet ventilator if available.
The recommended PPE for this skill are gloves and eye protection.
Once I've gathered all the necessary equipment and the patient is lying supine
I hyper extend the neck unless trauma is suspected.
and manage the patients airway with basic maneuvers and suplimental oxygen.
Palpating the neck to locate the cricoid thyroid membrane
between the thyroid and cricoid cartilage.
Cleans the site with an appropriate solution.
Stablize the site and insert the needle
at a 45 degree angle through the cricoid membrane.
Stabilize the needle and the advance the catheter.
Remove the needle and dispose of it in the sharps container.
Attach the syringe and aspirate to confirm placement in the trachea.
Attach BVM or jet ventilater.
Ventilate the patient one second for inflation
and two seconds for exhalation.
I would then have my partner continue to ventilate the patient
while I secure the device.
Once the device has been secured, I would observe the patient for chest rise
and auscultate lung sounds to ensure adequacy of ventilation.
I would then continue to ventilate the patient and observe
for possible complications such as subcutaneous emphysema
hemorrhage, hypoventilation
equipment failure, catheter kink
or false placement.