Advanced Medical Procedure for a field Tracheotomy?

Question

i hold my medical certifications but i never really thought about this question.. Can someone relay me some information on how EXACTLY to perform this life saving procedure? i believe i would contact a surgeon from local hospital to assist in preforming this...
however, say no surgeon is available...paramedics and on a call... mutual aid is no where around.. you have the necessary equipment... and your ready to cut. Can someone guide me on STEP BY STEP...everything from using the scalpel to cutting though the epiglottis, tracheal glands and the tracheal tube its self...how much 02 to release? (10L-15L?) and everything else needed...


just something i always wanted to know how to do... thank you!

Paul-NJ

geez michele dont get a heart attack.


i must want to know what the procedure is.....

Answer 1

This is a paramedic-level procedure (in some states, we paramedics aren't even allowed to do it). Even if I wrote out step by step directions, you still wouldn't know how to perform this procedure. I had to learn on a plastic manikin and it wasn't easy.
A "field tracheotomy" is actually called a "cricothyroidotomy" and it's a last ditch effort to provide an airway for someone who is either choking (and the object can't be reached by Magill forceps), or has sustained serious upper airway trauma. Most paramedics will only perform this procedure once in a career (if they're lucky).
Basically, it involves cutting the cricothyroid membrane and inserting a small ET tube in the opening. There's also ways to do it, using a special kit and a large bore needle. The cut needs to be exactly in the right place, because the area is fairly vascular, and it's easy to do more harm than good.
Truthfully, unless you are a paramedic or physician (even nurses don't get to perform this procedure) and have access to sterile equipment, an assortment of ET tubes, and other necessary stuff, then you shouldn't even be thinking about attempting this....I had to go to school for nearly two years to be able to learn this stuff, and if you are really interested in learning these kinds of medical procedures, then you might consider paramedic school.

BTW, the epiglottis isn't involved in performing a cricothyroidotomy.

Hope you have a wonderful day, and remember, if you try to perform a procedure outside your scope of practice, then you are practicing medicine without a license, and are very, very liable for any injuries or deaths that may occur...the Good Samaritan law won't cover you if you act outside the "first responder" scope of practice.

Answer 2

I'm wondering just what "certificates" you hold, as most of us in the medical field have heard about how this is performed. Asking this question in this forum is a bit frightening to me. This procedure is indeed life saving, and would only be done in the most extreme conditions. If you only have "some" medical "certificates" i.e., you are not a licensed professional, I suggest going to school to become licensed as you could do far more damage trying to be a hero. Also, you say you are medically trained, but I don't understand why you never "thought" about airway management, as it's the "A" in "The ABC's" of firstaid as well as CPR.

Answer 3

Advance Trauma Life Support is a good way to learn this technique. Try an Internet search for cricothyroidotomy. The potential for serious harm is significant for someone untrained. Major bleeding and serious airway damage can occur even in skilled hands. II have heard that some locales taught their paramedics to do this procedure, but then had to ban it as it was over-used.

Answer 4

Umm no! Even in the best skilled hands this procedure is serious, even in the best operating theater.

Answer 5

you sound so smart...