(11) Ventilate the patient in this manner:
(a) Open the oxygen valve slowly to allow a flow of gas into the
(b) To allow exhalation, close the valve. This stops the gas flow and
permits passive exhalation by elastic recoil of the lungs and the chest wall.
(c) The inflation-deflation time ratio should be approximately that of
normal respiration. This rate is 1:2. Also, the patient's respirations should be at least
12 times a minute.
(12) Check the adequacy of the patient's ventilations like this:
(a) Watch his chest to see if the chest rises and falls with each
(b) Listen to the patient's chest for breath sounds.
b. Procedure for Surgical Cricothyrotomy. Follow this procedure:
(1) Identify the cricothyroid membrane. Do this in the same way as for
Prepare the skin over the membrane with povidone-iodine.
Puncture the cricothyroid membrane in this manner:
(a) Make a skin incision over the lower one-half of the cricothyroid
(b) Carefully incise through the membrane.
Insert the scalpel handle into the incision and rotate 90 degrees to
open the airway.
(4) Inserting the cannula. A cannula is a tube inserted into the body to
withdraw or deliver fluid. Follow this procedure to insert the cannula:
(a) Keep your left hand on the larynx to stabilize the larynx.
(b) Pick up the cannula in your dominant hand. Place the cannula
through the puncture hole, with the cannula tip pointing toward the patient's feet.