Pediatric
Cricothyrotomy
Why make the change?

Quick Trach effectiveness

Well backed up by research

Options are limited

Simpler technique

Cheaper
Hyoid Bone
Thyroid
Prominence
Cricothyroid
Membrane
Cricoid Ring
Indications

Can’t intubate, can’t oxygenate, can’t ventilate.

Massive bleeding

Laryngospasm

Tissue swelling

Inability to remove foreign objects

Severe trauma

Trismus
Contraindications
Less
invasive technique is
available.
King #2 = 12 – 25 kg
Complications

Lack of confidence/Decision making ability

Small anatomy

Failure to access the airway

Catheter kink

Bleeding

Retaining CO2

Resistance to ventilations (high pressure when bagging)
Barriers to Success

Extremely infrequent skill

Hesitancy

Two personnel are committed to airway

Lack of anatomical knowledge

Unfamiliar with equipment
Procedure

Look for less invasive oxygenation techniques

Position patient properly exposing the front of the neck

Palpate CTM

Stabilize larynx with the non-dominant hand

Clean the area

Puncture CTM with the proper size over the needle cath

While puncturing, have a 10 ml syringe attached

While puncturing, withdraw air simultaneously

Remove needle and hold cath in place.

Ventilate

Secure with tape

ETCO2