Pediatrics Surgical Airway - Percutaneous Cricothyrotomy - Procedure Checklist

Supply Checklist:

 • Sterile gloves, chlorhexidine

 • Lidocaine with epi

 • 3-5mL syringe

 • Angiocath Set up:

 • 7.5 ETT Connector (or 7.0)

 • 3mL syringe (plunger out)

 • 14 gauge angiocath (can use catheter-over-neede in central line kit; cannot use autoguard needles)

 • Bag-Valve-Mask (BVM)

Steps:

1. Landmark CTM.

2. Clean skin.

3. Local anesthetic PRN.

4. Connect IV cannula to syringe.

5. Stabilize CTM membrane with hand.

6. Insert IV cannula+syringe through CTM at 45° angled caudally.

7. Advance while aspirating until pop + air in syringe - you are in trachea!

8. Slide plastic IV cannula into trachea until hub reaches skin.

9. Remove needle and syringe.

10. Confirm placement: connect syringe to angiocath and aspirate air.

11. Angiocath Set Up: connect angiocath-syringe-ETTConnector-BVM.

12. Ventilate with 1:4 I:E Ratio.

13. Secure Angiocath in place.

14. Make plan for definitive airway. This is a temporizing measure.



- Dr. Sarah Foohey @SarahFoohey



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