Friday, 10 April 2009

Cricothyroidotomy


Sorry another 'What do you use?' post.




In this one I'd like to know what you use for cricothyroidotomy. In the UK Paramedics are taught the traditional and less than ideal 'Get out of jail for 5 minutes' Needle cric using a large bore IV cannula and jet insluffation. Where I work we have the Quicktrach SAD (surgical airway device), pictured above, which I have used in anger and have also assisted in it's use. It's a good bit of kit. I've also found this link to it's new and improved model http://www.vbm-medical.com/cms/97-1-cricothyrotomy.html.

I'm not sure what devices are used by other UK services or in fact across the world. Although I do know that some US/Canadian EMS providers perform open cric with a scalpel.

4 comments:

medicblog999 said...

Hi Mac,

In NEAS, we use.....nothing!

They wont allow us to do needle cricothyroidotomy. Some new paramedics have been trained but we do not carry any kit for it.

The rationale is that our Medical director and clinical directorate believe that due to the rarity of using it, we cannot maintain the required level of competancy and it therefore becomes unsafe to do it.

I can see both sides of the argument, but we only do what we are allowed to do. I just hope that I dont find myself in a situation where it would have been needed.

mac said...

Unbelievable! Even a needle cric is better than nothing as you know. It is such a simple technique and potentially life saving. I thought it was a condition of HPC for all Paramedics to be able to do this.

Mart said...

EMAS - we use a 14g canula and attach a 5ml syringe to the leur lock port then take a length of o2 tube which convieniently fits perfectly in the syringe and cut a small notch in the pipe.

Cover the notch for 1 sec release for 5 - and drive it like you stole it!

Melissa said...

I have used the Melker cric kits in the past and found they work well. Quicktrachs are also popular. What I'm wondering, is if you are doing needle crics, why not just do retrograde intubation? There are many services here in the US that have gone to retrograde over the last few years.