همـ jihan ـسه
13-10-2007, 01:50 AM
CRICOTHYROTOMY
True emergencies calling for an opening into the upper airway may involve physicians who have not had surgical training, dentists, nurses, and medical aid personnel. These individuals may be relatively unskilled, even clumsy, lacking in confidence, nervous, tense, forgetful, and unsure of detailed neck anatomy
Notwithstanding the relative rarity of this emergency, it is imperative that the methods and instrumentation be such that the first performance is successful
Cricothyrotomy consists of making an opening through the thin membrane that lies between the thyroid and cricoid cartilages. In order to improve on available devices, a pocket-sized cricothyrotomy set has been constructed. The inadequacies of other technics and devices have been taken into consideration and obviated. The cricothyrotomy set is self-contained for anesthesia, vasoconstriction, incision, and cannulation. The set is packaged in a small, lightweight plastic container that maintains the sterility of the constituents
Used for emergency airway access when conventional endotracheal intubation cannot be performed. Airway access is achieved by standard wire-guided (Seldinger) technique via the cricothyroid membrane. Subsequent dilation of the tract and tracheal entrance site permits passage of the emergency airway. Airway catheter has radiopaque stripe and standard 15 mm connector. Special Operations Sets are custom packaged in slip peel-pouch design for easy transportation. Special Operations Sets combine 4.0 mm catheter with a 6.0 mm catheter in one package thereby reducing the number of kits needed in the field. Supplied sterile in peel-open packages. Intended for one-time use
Cricothyrotomy kit Includes
http://www.aic.cuhk.edu.hk/web8/0214_Cricothyrotomy_set.jpg
TFE Catheter Needle
Curved Radiopaque Dilator x2
Amplatz Extra Stiff Wire Guide with Flexible Tip
Emergency Cricothyrotomy Catheter 4mm and 6mm x2
Percutaneous Entry Needle x2
Disposable Scalpel
Syringe
Trach Tape
Dilational cricothyrotomy
Prepare equipment
Advance handle into airway catheter
http://www.aic.cuhk.edu.hk/web8/dilati1.gif
Identify cricothyroid membrane
http://www.aic.cuhk.edu.hk/web8/dilati2.gif
Palpate membrane, stabilize cartilage and make a midline incision
http://www.aic.cuhk.edu.hk/web8/dilati3.gif
Attach cannula to syringe filled with saline
and advance cannula through incision
and cricothyroid membrane
Confirm entry into airway by aspirating air
http://www.aic.cuhk.edu.hk/web8/dilati4.gif
Remove syring and trocar
and advance soft flexible
end of guidewire through catheter
until it is several centimetres into airway
http://www.aic.cuhk.edu.hk/web8/dilati5.gif
Remove cannula, leaving the guidewire in place
http://www.aic.cuhk.edu.hk/web8/dilati6.gif
Slide dilator-catheter unit over guidewire into airway
NB keep hold of part of the guidewire at all times
Do not advance the tip of dilator beyond the tip of guidewire
http://www.aic.cuhk.edu.hk/web8/dilati7.gif
Remove dilator and guidewire together
leaving the airway catheter in place
Connect the catheter to an appropriate ventilatory device
http://www.aic.cuhk.edu.hk/web8/dilati8.gif
True emergencies calling for an opening into the upper airway may involve physicians who have not had surgical training, dentists, nurses, and medical aid personnel. These individuals may be relatively unskilled, even clumsy, lacking in confidence, nervous, tense, forgetful, and unsure of detailed neck anatomy
Notwithstanding the relative rarity of this emergency, it is imperative that the methods and instrumentation be such that the first performance is successful
Cricothyrotomy consists of making an opening through the thin membrane that lies between the thyroid and cricoid cartilages. In order to improve on available devices, a pocket-sized cricothyrotomy set has been constructed. The inadequacies of other technics and devices have been taken into consideration and obviated. The cricothyrotomy set is self-contained for anesthesia, vasoconstriction, incision, and cannulation. The set is packaged in a small, lightweight plastic container that maintains the sterility of the constituents
Used for emergency airway access when conventional endotracheal intubation cannot be performed. Airway access is achieved by standard wire-guided (Seldinger) technique via the cricothyroid membrane. Subsequent dilation of the tract and tracheal entrance site permits passage of the emergency airway. Airway catheter has radiopaque stripe and standard 15 mm connector. Special Operations Sets are custom packaged in slip peel-pouch design for easy transportation. Special Operations Sets combine 4.0 mm catheter with a 6.0 mm catheter in one package thereby reducing the number of kits needed in the field. Supplied sterile in peel-open packages. Intended for one-time use
Cricothyrotomy kit Includes
http://www.aic.cuhk.edu.hk/web8/0214_Cricothyrotomy_set.jpg
TFE Catheter Needle
Curved Radiopaque Dilator x2
Amplatz Extra Stiff Wire Guide with Flexible Tip
Emergency Cricothyrotomy Catheter 4mm and 6mm x2
Percutaneous Entry Needle x2
Disposable Scalpel
Syringe
Trach Tape
Dilational cricothyrotomy
Prepare equipment
Advance handle into airway catheter
http://www.aic.cuhk.edu.hk/web8/dilati1.gif
Identify cricothyroid membrane
http://www.aic.cuhk.edu.hk/web8/dilati2.gif
Palpate membrane, stabilize cartilage and make a midline incision
http://www.aic.cuhk.edu.hk/web8/dilati3.gif
Attach cannula to syringe filled with saline
and advance cannula through incision
and cricothyroid membrane
Confirm entry into airway by aspirating air
http://www.aic.cuhk.edu.hk/web8/dilati4.gif
Remove syring and trocar
and advance soft flexible
end of guidewire through catheter
until it is several centimetres into airway
http://www.aic.cuhk.edu.hk/web8/dilati5.gif
Remove cannula, leaving the guidewire in place
http://www.aic.cuhk.edu.hk/web8/dilati6.gif
Slide dilator-catheter unit over guidewire into airway
NB keep hold of part of the guidewire at all times
Do not advance the tip of dilator beyond the tip of guidewire
http://www.aic.cuhk.edu.hk/web8/dilati7.gif
Remove dilator and guidewire together
leaving the airway catheter in place
Connect the catheter to an appropriate ventilatory device
http://www.aic.cuhk.edu.hk/web8/dilati8.gif