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Thread: Cricothyrotomy Kits

  1. #21
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    Quote Originally Posted by TacMedic556 View Post
    Make your own kit.
    This.
    The only things I have to add are:
    1/4 in cotton webbing or something to secure the tube. If you preattach it, make sure you practice like that because crap hanging off the tube can be distracting.
    Optionally, small set of curved Kelly's in addition to the hook. Make sure there is a cover on the point of the hook.
    I like a retractable safety scalpel for this type of kit, and when I practice, I always retract the blade, just like I practice safing my weapon.
    Consider packing a flush instead of an empty syringe.
    Vacuum sealers made for food work well for cric kits. Label it in big letters, make tear starting cuts with shears in several places, and mark the cuts with black sharpie. We lose IQ points rapidly under stress.

    Edit to add: a couple of 4x4's are a good idea

    Disclaimer: all of my cricothyrotomy practice has been on cadavers, animal models, and mannequins.
    Last edited by 1168; 09-23-17 at 05:58. Reason: Content

  2. #22
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    We have some needle cric kits that are pretty slick (stocked in each OR). I suspect the rate of successful perc trachs in the field (never mind open approach) is very, very low. The “best” trachs I’ve seen have been slash trachs by trauma surgeons where they just shove an ETT. As a CRNA, I hope to see more and more pre-hospital providers (military and civilian) using video scopes - that would save some lives.

  3. #23
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    Quote Originally Posted by mass-diver View Post
    We have some needle cric kits that are pretty slick (stocked in each OR). I suspect the rate of successful perc trachs in the field (never mind open approach) is very, very low. The “best” trachs I’ve seen have been slash trachs by trauma surgeons where they just shove an ETT. As a CRNA, I hope to see more and more pre-hospital providers (military and civilian) using video scopes - that would save some lives.
    Glidescopes all around here where I work, including PACU, ED, and all of the ambulances. Really takes the mystery (and chipped teeth) out of endotrachael intubation. Between needle crics and Glidescopes, if I ever get called to provide an airway, I know that we are in deep shit.

  4. #24
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    Videolaryngoscopes have undoubtedly changed the whole landscape for difficult airway management, and they are good tools. They aren't perfect, however, with the notable limitations of: (1) ability to view the cords but unable to align a pathway to pass an endotracheal tube, and (2) inability to image due to blood or secretions. Also, it is simply not possible to intubate from above in some patients, such as in severe head/neck trauma or airway tumors, for example.

  5. #25
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    In my 911 service we now have both video scopes and needle crics. I’m skeptical about the uncuffed tube on the needle cric, but thrilled about the video scopes.

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