b. Disadvantages.
(1)
Requires some surgical skill and knowledge of anatomy.
(2) Only good for a relatively short time (24 to 48 hours).
c. Contraindications. A surgical cricothyroidotomy should not be performed on
children under 12 years of age. In cases where standard airway maneuvers are
unsuccessful, a less invasive needle cricothyroidotomy is indicated.
d. Complications of Cricothyroidotomy.
(1)
Asphyxiation.
(2)
Aspiration of blood or stomach contents.
(3)
Cellulitis.
(4)
Esophageal perforation or laceration.
(5)
Incorrect placement (most commonly through the thyrohyoid
membrane).
(6)
False passage.
(7)
Subcutaneous or mediastinal emphysema.
e. Equipment Needed.
(1)
Body sbstance iolation (BSI).
(2)
Antimicrobial solution.
(3)
Local anesthetic (lidocaine 1 percent with epinepherine).
(4) Number 3 scalpel handle with a Number10 blade (for skin) and a
Number 11 blade (to incise the cricothyroid membrane).
(5)
Hemostat (curved mosquito or curved Kelly).
(6)
Oxygen source.
MD0542
2-14