(c) Using controlled force, insert the cannula and advance it until the
flange is flush with the skin.
(d)
If you are using a cuffed tracheostomy tube, inflate the cuff.
(5)
Check for correct placement like this:
(a) Listen and feel for air flow through the cannula.
(b) Ventilate through the cannula. The patient's chest should rise and
fall with each ventilation. The patient's breath sounds should be audible on both sides
of his chest.
(6)
Secure the cannula with tapes.
NOTE:
Due to its potential hazards, cricothyrotomy should be performed ONLY by
personnel who have been thoroughly trained in this method and who have
been approved by their physician directors to use this method.
3-7.
WOUND DEBRIDEMENT
Wound debridement is the surgical removal of dead, injured, or infected tissue
from around a wound. This includes the removal of foreign matter from the wound
surface. Wound debridement should be rational rather than radical.
a. Excisement. Do not excise the wound to the extent that viable muscle is
intentionally excised circumferentially. Instead, excise to open the wound so that the
wound can drain. At the same time, excise a muscle if it is severely damaged .
b. Goals of Wound Debridement. Included are the following:
(1)
Relive excessive tension within the wound.
(2) Rid the wound of dead tissue and massive hematoma (mass of blood
outside blood vessels, causing swelling).
(3)
3-8.
CLOSING
Trauma strikes all ages. Generally, trauma is swift in onset and slow in recovery,
with many problems along the way for those trying to manage its course. Trauma can
have a devastating effect on the members of our society. Prevention is paramount.
Where prevention fails, we must be knowledgeable and prepared to meet the patient's
immediate needs.
MD0574
3-20