Surgical Airway Techniques Periprocedural Care

Updated: Feb 13, 2020
  • Author: Joshua E Markowitz, MD, FACEP, RDMS, SAIUM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Periprocedural Care

Equipment

Equipment for open cricothyroidotomy (cricothyrotomy) includes the following:

  • Cuffed, nonfenestrated tracheostomy tubes, No. 4 and No. 5 
  • Scalpel, No. 11
  • Trousseau dilator
  • Tracheal hook
  • 4 × 4 gauze/sponges
  • Optional equipment - Small hemostats (2), surgical drapes, 1% lidocaine with syringe and needle

Equipment for needle cricothyroidotomy includes the following:

  • Over-the-needle catheter, 12 or 14 gauge, 8.5 cm
  • Over-the-needle catheter, 16 or 18 gauge, 8.5 cm (for pediatric patients)
  • Syringe, 10 mL
  • Scalpel, No. 11
  • 4 × 4 gauze/sponges
  • Nasal cannula or oxygen tubing with Y-connector
  • Optional equipment - Surgical drapes, 1% lidocaine with syringe and needle

Equipment for percutaneous cricothyroidotomy using the Seldinger technique includes the following:

  • Cricothyrotome kit
  • Scalpel, No. 11
  • 4 × 4 gauze/sponges
  • Optional equipment - Surgical drapes, 1% lidocaine with syringe and needle
Next:

Patient Preparation

Anesthesia

If time permits and the patient is not unresponsive, injection of the skin and subcutaneous tissue over the cricothyroid membrane with 1% lidocaine solution provides adequate anesthesia.

Positioning

Position the patient supine, with the neck in a neutral position.

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