Category Archives: Surgical airway

Confined Space Airway Management

Ross’s talk from the 2015 SMACCdub meeting, with credit to #SMACC and the Intensive Care Network.

This and many other talks available on the SMACC home pages.

Click here for the slides, podcast and original abstract on ICN.

How to build a breathing, bleeding cricothyroidotomy simulator

Jean-Christopher Ozenne (@JCOzenne) of Gouvieux, France has generously published this great video on how to build “The Mustache” – a breathing, bleeding cricothyroidotomy simulator – using cheap and ubiquitous equipment.  Can’t wait to try this one out…I particularly like the artistic touch.  To paraphrase V himself:  A cric trainer without bleeding is not a cric trainer worth having.

Video: Surgical cricothyroidotomy (DAS 2015)

Quick overview of the surgical cricothyroidotomy technique as presented in the 2015 Difficult Airway Society guidelines.  This is simply presenting the technique in a manikin model, not intended as a debate about the relative merits of needle vs. surgical, blade vs. hook, scalpel-finger-bougie vs. scalpel-bougie-tube, etc!

Don’t forget to wear your PPE (gloves, mask, eye protection) and appropriately secure the tube afterwards.

As always, constructive criticism and suggestions for improvement are always welcomed in the comments section.

Cannula Cricothyroidotomy

In response to a great Twitter discussion with PHARM‘s @ketaminh:

See Minh le Cong’s PHARM blog post, video and podcast here.  Please note that using a BVM is not the advised technique of oxygenation, but is used here because we don’t have an oxygen source in the skills lab.

Lots of ensuing discussion of the ideal angle of puncture of the cricothyroid membrane.  90 degrees (perpendicular to skin) has least risk of puncturing posterior wall of the trachea, but greatest risk of cannula kinking.  I advocate around 60 degrees for puncture and then decreasing angle to advance cannula: