Name: ACA- Hung 4e- Scalpel Bougie Cricothyrotomy

Description: ACA- Hung 4e- Scalpel Bougie Cricothyrotomy

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Duration: T00H02M35S

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Content URL: https://cadmoreoriginalmedia.blob.core.windows.net/cbffccd9-5e55-4c5d-ab95-32b5433f92b7/Scalpel Bougie Cricothyrotomy.mov?sv=2019-02-02&sr=c&sig=IKrVpQlNXb10q6zYC8IJGbDU5feXfOfb8Y%2FGp4kXX%2F8%3D&st=2025-01-15T10%3A02%3A50Z&se=2025-01-15T12%3A07%3A50Z&sp=r

Upload Date: 2023-11-24T00:00:00.0000000

Transcript: Language: EN.
Segment:0 .
The open cricothyrotomy is a life-saving procedure in patients with a failed airway. While many cricothyrotomy techniques have been suggested, only two open cricothyrotomies will be presented in this video. The equipment required includes a scalpel, a tracheal introducer or a bougie, and a size 6 or 7 mm endotracheal tube. The vertical incision technique is most suitable if the landmark of the interior neck cannot be easily identified.
With the index finger and thumb of the non-dominant hand immobilizing the trachea, a 4 cm vertical midline skin incision is made over the cricothyroid space. The index finger is inserted through the skin incision to locate the cricothyroid membrane. A transverse incision of the cricothyroid membrane is then made at the superior border of the cricoid cartilage. The little finger is inserted through the membrane to dilate the incision.
The bougie is then inserted through the incision into the trachea. An endotracheal tube is advanced over the bougie into the trachea. Following the removal of the bougie and inflation of the cuff, correct tube placement should be confirmed by end tidal CO2 and by auscultation. The horizontal incision technique should be only used if the landmark of the cricothyroid membrane can be identified easily.
A 2 cm horizontal incision of the skin and then cricothyroid membrane is made. The little finger is inserted through the membrane to dilate the incision. A bougie can then be inserted through the incision into the trachea, and an endotracheal tube can then be advanced over the bougie into the trachea. Similarly, following the removal of the bougie and inflation of the cuff, correct tube placement should be confirmed by end tidal CO2 and auscultation.
In summary, the open cricothyrotomy remains an important airway rescue technique. With proper preparation, the technique can be performed easily. A vertical incision should be made if the landmark of the cricothyroid membrane cannot be identified. However, if the cricothyroid membrane can be identified easily, a single horizontal incision over the skin and cricothyroid membrane is the simpler technique.

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