Consider as primary airway in massive maxfax trauma

Equipment

• scalpel
• tracheal dilators
• tracheal dilators
• 15ch bougie
• 10ml syringe / tube tie

Technique

• Identify the cricothyroid membrane (fig 1). Clean the area.
• Use a scalpel to make a deep horizontal incision through skin and cricothyroid membrane (fig 2).
• Remove scalpel and insert dilators, spreading to hold open the hole (fig 3).
• Insert size 6.0 tracheostomy tube and inflate cuff, bougie may be helpful.
• Attach capnograph and confirm EtCO2 detection, auscultate.
• After oxygenating, pass suction catheter for blood / secretions.
• Secure tube with tracheostomy tie.