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Clinical Indications:

    1. Failed airway protocol (ET or combitube not successful options)

    2. Management of an airway when standard airway procedures cannot be accomplished

    3. Massive facial or neck trauma preventing standard airway procedures

    4. Airway occlusion which prevents standard airway procedures

    5.unable to perform surgical cricothyrotomy


    1. Determine need for procedure

    2. Prepare equipment

    3. Have suction available

    4. Preoxygenate ( if possible)

    5. Position on back with head slightly hyperextended unless contraindicated

    6. Locate cricothyroid membrane between cricoid and thyroid cartilage

    7. Clean with alcohol / betadine

    8. Puncture membrane with #14 or # 16 gauge angiocath (needle angled 45 -60 degrees to feet)

    9. Advance angiocath into trachea until pop is felt and air return noted

    10. Remove needle and ventilate

    11.(attach 3 mm ET tube adapter to angiocath or other alternative means of ventilation)

    12. Primary tube confirmation

    13. Secondary tube confirmation

    14. Secure device

    15. Continuous patient monitoring

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