(b) Endotracheal tube. A modified ET tube (7.0 to 7.5 mm) will suffice.
Simply remove the connector from the non-cuffed end and cut the tube just above
where the inflation line enters the endotracheal tube and replace the connector. Do not
cut the inflation line since this will prevent you from inflating the endotracheal cuff to
help seal the airway.
(1) Place the patient in the supine position with the neck moderately
(2) Identify the landmarks. Palpate the "V" notch just above the thyroid
cartilage (Adam's apple), which feels like a high, sharp bump. Stabilize the larynx
between your thumb and middle fingers while you palpate the site with your index
finger. Once you have located the "V" notch, slide your index finger down into the
depression between the thyroid and cricoid cartilages; this is the cricothyroid
(3) Prepare the area with an antimicrobial solution and infiltrate the site with
the anesthetic (if time will permit). Utilize a sterile field if available.
Stabilize the larynx and thyroid cartilage with your non-dominant hand.
(5) Make a 2 to 3 cm longitudinal skin incision directly over the cricothyroid
membrane (mid-sagittal), carefully incise through the membrane (see figure 2-10).
Figure 2-10. Cricothyroid membrane.