#8 Crash Cricothyrotomy Learning Objectives – Review Prep team/plan/room/equipment Discuss Difficult Airway Algorithm Describe a “Crash Airway” Declare:

Slides:

Advertisements

Similar presentations

Bougie ET introducer.

Advertisements

DIFFICULT AIRWAY ASSESSMENT AND MANAGEMENT

Non-Visual Intubation Techniques Orlando Hung Departments of Anesthesia, Surgery and Pharmacology, Dalhousie University Halifax, Nova Scotia.

Can’t Intubate Can’t Oxygenate (CICO)

Advanced Airway Management

#5 Intro to EM Airway Management- RSI Pharmacology Andrew Brainard 1.

Bed head signs These PowerPoint slides are designed for you to adapt to your local procedures. You can cut and paste the relevant images on the subsequent.

Difficult Airway Trolley (DAT) What does the ideal DAT look like? Top work surface and 4-5 drawers Mobile Robust Stocked in a logical sequence Clearly.

DAS Guidelines update April 2015

#8 Essential Emergency Airway Care- Surgical Airways 1 Andrew Brainard, MD, MPH, FACEM, FACEM

Failed Intubation in Children Dr Philip Ragg Royal Children’s Hospital Melbourne.

Emergency Medicine Some Tools for Managing the Difficult Airway Joe Lex, MD, FAAEM Temple University Philadelphia, PA.

The Difficult and Failed Airway Principles of Rapid Sequence Intubation Jason Carter, B.S., L.P.

Airway Anatomy Soft palate Hard palate Nasopharynx Oropharynx Hypopharynx Tongue Thyroid cartilage.

#3 Intro to EM Airway Management- Assessment and SupraGlottic Airways (SGA) Andrew Brainard 1.

#1 Essential Emergency Airway Care- Airway Preparation

A question you always want to know about tracheal intubation: What to do if I can’t intubate a patient?

Airway and Tracheostomy

TRACHEOSTOMY CARE AND EMERGENCIES. Indications for tracheostomy  Airway  Severe Facial Trauma,  Head and neck cancers / tumours  Acute Angioedema.

GSACEP core man LECTURE series: Airway management Lauren Oliveira, DO LT, MC, USN Updated: 01MAR2013.

Difficult tracheal intubation

The Emergency Airway National Review Course in Emergency Medicine Kirk Magee MD, MSc, FRCPC Associate Professor Dalhousie Department of Emergency Medicine.

#6 Essential Emergency Airway Care-Video Laryngoscopy

Orotracheal intubation เพชรรัตน์ วิสุทธิเมธีกร, พบ., ว. ว. ( วิสัญญี ) ภาควิชาวิสัญญีวิทยา วิทยาลัยแพทยศาสตร์ กรุงเทพมหานครและวชิรพยาบาล.

What equipment should be in your Difficult Airway Cart ?

Airway Management GMVEMSC Education Committee. Objectives Review proper airway management Review assessment Review adjuncts and proper use.

Airway 101 UCSF-Fresno June 19, 2015.

Seldinger Cricothyrotomy 2002 ACP Recert. Agenda MORNING ROTATION 08:45Emergency Advanced Airway 09:1512 Lead Acquisition 09:45Pediatric Review 10:30Break.

DIFFICULT AIRWAY MANAGEMENT

Abdullah Alsakka E.M. Consultant. Questions For The Emergency Physician: 1. Can I predict the difficult airway? 2. How often can I expect to be faced.

Sydney Clinical Skills and Simulation Centre Management of the Critically Obstructed Airway Session 5: Infraglottic Airway Rescue Practical Session.

Emergency Airway Management ________________________________ Mark L. Freedman MD, FRCP.

Airway Management The Medic One Way… By Zachary Wm. Drathman.

Difficult Airway Management Techniques

Assessing the Difficult Airway in the ED

Difficult Airway. Definition The clinical situation in which a conventionally trained anesthesiologist experiences difficulty with mask ventilation, difficulty.

Care of the Client with an Artificial Airway

Emergency in Dentistry: Part I B asic life support (BLS) - Sequence of BLS - Sequence of BLS - Equipment - Equipment - Techniques - Techniques.

Procedures. Chapter 15 page 448 Objectives Spell and define key terms State the purpose of endotracheal intubation and describe how to assist with this.

The Emergency Airway National Review Course in Emergency Medicine Kirk Magee MD, MSc, FRCPC Associate Professor Dalhousie Department of Emergency Medicine.

1 1 Case 1 Respiratory Emergencies © 2001 American Heart Association.

Intro to:. Objectives  Define RSI  Identify the Indicators for using RSI  Identify the relative contraindications and disadvantages of RSI  Discuss.

Seldinger Cricothyrotomy Review 2005 ACP Recert (Enhansed)

Q4.10 – October 2010Airway Management Essentials© Copyright 2010 American Safety and Health Institute Airway Management Essentials.

Cricothyrotomy Indications and Use for the NH Paramedic New Hampshire Division of Fire Standards & Training and Emergency Medical Services.

Facilitated Intubation t Sedation (decrease LOC) –Versed (January 2002 with patch) concerns for hypotensive patients helps blunt sympathetic response amnesia.

Indicate on this diagram any sutures in place This patient has a New TRACHEOSTOMY UPPER AIRWAY ABNORMALITY: Yes / No Document laryngoscopy grade and notes.

Emergency Cricothyrotomy Protocol Needle Cricothyrotomy: 7. Attach a 14 gauge over-the-needle catheter to a 10 cc syringe filled with saline. Carefully.

Surgical and Nonsurgical Cricothyrotomy

DIFFICULT AIRWAY IN THE ICU Dr Anitha Shenoy Professor and Head of Anaesthesiology Kasturba Medical College, Manipal.

Upper Airway management

Seldinger Cricothyrotomy Review 2005 ACP Recert (Enhansed)

Emergency Cricothyrotomy: Comparing Four Methods Summary and Comment by Aaron E. Bair, MD, MSc, FAAEM, FACEP Published in Journal Watch Emergency Medicine.

Beyond the algorithm... John Moore Teaching the teachers Tracheostomy Safety Project 2011.

#8 Essential Emergency Airway Care- Paediatric Considerations- Anatomic, physiological, dosing, and equipment issues 1 Andrew Brainard, MD, MPH, FACEM,

CAP Module 4 - Difficult Airway Management (GHEMS_April2015)

Airway Year 4 tutorial A B C D E. Goals of airway management Relieve airway obstruction & so maintain ability to adequately ventilate Relieve airway obstruction.

Indicate on this diagram any sutures in place This patient has a New TRACHEOSTOMY UPPER AIRWAY ABNORMALITY: Yes / No Document laryngoscopy grade and notes.

Airway Training WGH Simulation afternoon WGH 22/01/2016 Thomas Bloomfield ST4 Anaesthetics.

Airway. Learning Objectives At the end of this session you will be able to Describe the main aims of airway management in trauma Predict specific difficulties.

Endotracheal Intubation – Rapid Sequence Intubation

So you want to Dominate the Difficult Airway? By Kane Guthrie Clinical Nurse SCGH ED.

ALFRED ICU INTUBATION CHECKLIST

Cricothyrotomy Education QI Project

Difficult Airway.

Respiratory Emergencies

Difficult Airway Fundamentals

CAP – Module 4 DIFFICULT AIRWAY MANAGEMENT

Presentation transcript:

#8 Crash Cricothyrotomy Learning Objectives – Review Prep team/plan/room/equipment Discuss Difficult Airway Algorithm Describe a “Crash Airway” Declare: Can’t Intubate, Can’t Oxygenate! – Surgical Cric Locate equipment Double Setup Proper technique – Scalpel – Bougie – Tube Indications R40: 40 y/o M swollen tongue, difficulty breathing – Hx angioedema – Obtunded, GCS 6, SaO2 80% On Arrival – Sitting Up, Nasal O 2, rebreather 0 2 >15lpm – SaO2 75% and GCS 5 – LEMON Protruding tongue, Swollen face, 0-3-2, stridor – Consultant suggests Crash Cric Declare: Can’t Intubate, Can’t Oxygenate – Skip Checklist +/- sedation/paralysis Difficult Airway Call (888) Crash Cricothyrotomy – End scenario after tube confirmation

Locate Cric Kit

Cric Assessment Laryngeal Handshake Ultrasound SHORT S: surgery (previous) H: haematoma (swelling) O: obesity R: radiation T: tumor

Indications Cant intubate, can’t oxygenate (CICO). When an experienced clinician thinks it will be safer than intubation from the top. – Continue to attempt to ventilate from the top with an LMA/BVM Age cut-offs? – APLS suggests <12y/o – Some say <6y/o – Others say <3y/o – AKA: it depends

Preparation Can use the “double prep” – Assess, clean, and mark neck

Equipment Simple Cric Kit – Scalpel – ( Bougie on Airway Cart) – 6-0 endotracheal tube (cuffed) – Dressing Pack Skin Marker Antiseptic KY 10ml syringe Blue pad Cook surgical-and percutaneous airway kit

Cric Technique Scalpel-Bougie-Tube Optimize patient Oxygenate with BVM/LMA Locate cricothyroid membrane Vertical cut skin Horizontal cut membrane Bougie 6-0 ETT over bougie until cuff enters Confirm and ventilate Bougie Cric (7min)

We have prepared a “double setup” We are are ready for an emergent cricothyrotomy We can not intubate and we can not oxygenate. Declare an 888 airway emergency Our plan is: A- Attempt direct/bougie/tube B- Oxygenate with #5 I-LMA C- Perform scalpel/bougie/cric if sats <80% D- Perform open cric Questions? Oxygenate the patient! Airway Briefing and checklist