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| {{SI}}
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| {{CMG}}
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| ==Overview==
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| '''Cricothyrotomy''' is a [[surgical]] procedure used to rapidly provide ventilation and oxygenation in patients whose airway can not be maintained through other methods. This is done by creating a temporary airway through the [[cricothyroid membrane]]. This technique is considered easier and faster than a [[tracheostomy]], but is only used when oral or nasual [[intubation]] is not possible in the patient. This procedure does not require manipulation of the [[cervical spine]]. However, it does require special training and authorization from local [[medical direction]] prior to being performed, dependending on local [[medical protocol]]s.
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| ==Indications==
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| *Severe facial or nasal injuries (that do not allow oral or nasal intubation)
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| *Massive midfacial trauma
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| *Possible spinal trauma preventing adequate ventilation
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| *[[Anaphylaxis]]
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| *Chemical inhalating injuries
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| ==Contraindications==
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| *Inability to identify landmarks ([[cricothyroid membrane]])
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| *Underlying anatomical abnormality ([[tumor]])
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| *Tracheal transection
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| *Acute laryngeal disease by infection or trauma
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| *Small children under 10 years old (a 12-14 gauge catheter over the needle may be safer)
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| ==Summarized Technique==
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| #With a scalpel, create a 2 cm horizontal incision through the cricothyroid membrane
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| #Open the hole by rotating the scapel 90 degrees or by using a clamp
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| #Insert a size 6 or 7 [[Endotracheal tube]] or [[tracheostomy]] tube
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| #Inflate the cuff and secure the tube
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| #Provide venilation via a Bag-Valve device with the highest available concentration of oxygen
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| #Determine if ventilation was successful (bilateral ausculation and observing chest rise and fall)
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| No attempt should be made to remove the [[Endotracheal tube]] in a prehospital setting.
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| ==References==
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| *''Mosby's Paramedic Textbook, Edition 3'', Mick J. Sanders. 2005, St. Louis, MI: ELSEVIER MOSBY.
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| {{SIB}}
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| [[Category:Surgical procedures]]
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| [[Category:Emergency medicine]]
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