How would you perform a needle cricothryroidotomy?
- This is an emergency procedure in a "can't intubate, can't ventilate" scenario.
- I would maintain asepsis throughout as much as possible. I would prepare a 14G needle connected to a 5/10ml syringe half-filled with sterile water.
- If I could safely extend the neck I would do so and palpate the cricothyroid recess between the thyroid notch and cricoid cartilage.
- Whilst holding the larynx firmly I would insert in needle into the midline of the recess aiming caudally and continually aspirate watching for air bubbles in the syringe. Once bubbles are seen I would remove the syringe and needle and repeat the aspiration to ensure air is entering the syringe freely. Once placement is confirmed, I would attach to an oxygen supply.
- I would ensure help was on its way so that a more definitive airway could be established.