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    Surgical Airway

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    Arnold Daniel
    This document discusses surgical airway procedures including cricothyrotomy, retrograde tracheal intubation, and needle cricothyrotomy. It outlines the indications, contraindications, relevant anatomy, and procedures for each technique. Complications are also reviewed. The goal is to provide emergency airway access when other methods are unsuccessful or contraindicated due to trauma, obstruction, or difficult anatomy.

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    Attribution Non-Commercial (BY-NC)
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    Surgical Airway

    Uploaded by

    Arnold Daniel
    94 views13 pages
    This document discusses surgical airway procedures including cricothyrotomy, retrograde tracheal intubation, and needle cricothyrotomy. It outlines the indications, contraindications, relevant anatomy, and procedures for each technique. Complications are also reviewed. The goal is to provide emergency airway access when other methods are unsuccessful or contraindicated due to trauma, obstruction, or difficult anatomy.

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    This document discusses surgical airway procedures including cricothyrotomy, retrograde tracheal intubation, and needle cricothyrotomy. It outlines the indications, contraindications, relevant anatomy, and procedures for each technique. Complications are also reviewed. The goal is to provide emergency airway access when other methods are unsuccessful or contraindicated due to trauma, obstruction, or difficult anatomy.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    94 views13 pages

    Surgical Airway

    Uploaded by

    Arnold Daniel
    This document discusses surgical airway procedures including cricothyrotomy, retrograde tracheal intubation, and needle cricothyrotomy. It outlines the indications, contraindications, relevant anatomy, and procedures for each technique. Complications are also reviewed. The goal is to provide emergency airway access when other methods are unsuccessful or contraindicated due to trauma, obstruction, or difficult anatomy.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 13

    Surgical airway

    SURGICAL AIRWAYS
    Cricothyrotomy
    Indications (Identified need for intubation)
    Maxillofacial trauma Oropharyngeal obstruction
    Edema FBAO Mass Lesion Cancer

    Unsuccessful oral/nasal tracheal Difficult anatomy Massive hemorrhage/regurgitation

    SURGICAL AIRWAYS
    Cricothyrotomy (cont..)
    Contraindications:
    Age <10-12 Laryngeal crush injury Laryngeal tumor/stricture Tracheal transsection subglottic stenosis Expanding hematoma Coagulopathy Unfamiliar w/ procedure

    SURGICAL AIRWAYS
    Anatomy:
    Thyroid cartilage Cricoid ring Cricoid cartilage Thyroid gland Trachea Major vessels

    SURGICAL AIRWAYS

    Netter; Atlas of Human Anatomy

    SURGICAL AIRWAYS
    Procedure:
    Identify thyroid cartilage
    Cricothyroid membrane

    Vertical incision through skin


    Prep prior Incise membrane

    Open incision
    Dilator/tracheal hook

    Insert ETT/Trach tube


    Ventilate patient

    SURGICAL AIRWAYS
    Complications:
    Incorrect placement Long execution time Hemorrhage Passage sub Q Plugging Pneumomediastinum Aspiration etc.

    Anderson; Grants Atlas of Anatomy

    SURGICAL AIRWAYS

    SURGICAL AIRWAYS
    Retrograde Tracheal Intubation (RTI):
    Indications
    Abnormal anatomy
    Pt. W/ epiglottitis Severe kyphosis Cervical spondylosis

    Trauma Reasonable alternative to Surg and Needle Crike

    SURGICAL AIRWAYS
    RTI (cont...):
    Contraindications
    Trismus (w/o paralytic) Coagulopathy Enlarged thyroid

    Procedure:
    Supplemental O2 Catheter over needle into CTM Insert guidewire through catheter Visualize guidewire and pass tube

    Dailey; The airway: emergency management

    SURGICAL AIRWAYS
    Needle Cricothyrotomy
    Indications
    Same as for any surgical airway Considered safer and quicker than surgical crike Will not compromise c-spine in trauma pt.

    Contraindications
    Total obstruction at or near the cords

    Complications
    Misdirection Puncture tracheal wall Local cord damage Does not prevent aspiration!

    SURGICAL AIRWAYS
    Needle Cricothyrotomy
    Procedure
    Supplemental O2 Catheter over needle into CTM (at least 14 ga) Attach to high pressure O2 source (50psi) Ventilate using valve or interrupter type device

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