Emergency Cricothyrotomy by Briana Thomas

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by Briana Lawson2 views·Updated Aug 12, 2022
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  1. Hello everyone.
  2. My name is Brianna thomas and I'm currently a
  3. DNP student at the University of texas Health Science center
  4. at Houston in the acute care nurse practitioner track
  5. and today I will be presenting on emergency craig.
  6. Both Iran amis.
  7. Emergency craig
  8. Tyrod amIS are considered to be last resort airways and are used and can't intubate,
  9. can't oxygenate situations.
  10. There are multiple techniques used to insert the airway which I
  11. will review in later slides and the cpt code and I.
  12. C. D. 10 codes are included for billing purposes
  13. patients can present of all ages with different medical
  14. injuries or traumas including oral or maxillofacial trauma,
  15. cervical spine, trauma, profuse oral hemorrhage,
  16. copious nemesis and an atomic abnormalities.
  17. These different conditions make the patient at risk for a difficult
  18. airway insertion and they might need an emergency Creek with Iraq.
  19. To me if typical tracheal intubation or laryngeal face mask cannot be performed.
  20. Other risk factors for a difficult airway
  21. include if the patient has recently had neck
  22. surgery or there's presence of a scar around the neck hematoma around the airway,
  23. obesity, radiation or other trauma.
  24. Next I will be reviewing the path of physiology including the anatomy and airway.
  25. It is imperative that the advanced practice provider be
  26. able to locate the cry co thyroid membrane.
  27. If they are considering to insert an emergency cry koth Iraq to me.
  28. The creek.
  29. Oh thyroid membrane is bordered superior early by the thyroid cartilage,
  30. inferior early by the creek oid cartilage and laterally by creek.
  31. Oh thyroid
  32. muscles.
  33. It is important for the advanced practice provider to
  34. palpate the laryngeal prominence which is the adam's apple,
  35. and then to inferior early palpate the signet ring.
  36. The cricket thyroid membrane feels like a slight depression
  37. between the thyroid cartilage and the creek oid cartilage,
  38. the path of physiology for a crack oath I rata me ultimately comes
  39. down to whether or not an airway can be established as previously mentioned.
  40. If tracheal intubation or face mask or laryngeal mask are unsuccessful,
  41. then emergency cry Kathrada me must be performed
  42. in order to maintain a patient's airway.
  43. There are contraindications listed on this slide,
  44. which will be reviewed in later slides.
  45. Next, I will review the diagnosis process behind an emergency creek with Iraq To me,
  46. barriers to insertion are often mainly cognitive because this
  47. airway is not routinely inserted on a regular basis.
  48. Oftentimes the perception of failure can cause inappropriate
  49. Delaire delays in establishing a patient's airway.
  50. There is time taken to act and time taken to prepare
  51. Making regular practice on simulators and cadavers necessary.
  52. The difficult airway algorithm,
  53. which will be pictured on later slides was published by the difficult airway
  54. society to help narrow down the diagnosis for an emergency craig growth arata me
  55. prior to insertion.
  56. There should be an airway plan present including medications
  57. and supplies which should be verbalized to the team.
  58. The advanced practice providers should identify anatomical
  59. landmarks in case of craig becomes necessary.
  60. Next I will review the steps description
  61. and risks and contraindications of the procedure
  62. Pictured on this slide is the difficult airway algorithm which provides a pathway
  63. in order to make the decision for an emergency Craig with Iran.
  64. To me as previously mentioned,
  65. it is a last resort airway and involves an incision in the crack
  66. third membrane for an 82.
  67. The most common complication includes incorrect to placement.
  68. However it is considered more straightforward than a tracheostomy,
  69. which is why it is commonly used in an emergency setting.
  70. There are no absolute contra indications for the
  71. insertion of an emergency Cranko thyroid membrane airway.
  72. And as we all know from our A. B. C. S. Airway comes first
  73. There is a risk of the development of subs
  74. excuse me,
  75. sub global stenosis which can be related to acute
  76. laryngeal disease or a kid's age from 5-12.
  77. As you can see in the image,
  78. subglacial stenosis can lead to severe restrictions of
  79. the airway and can even occlude the airway.
  80. So it is an important complication to be aware of.
  81. As previously mentioned,
  82. there are multiple techniques that can be used
  83. for the insertion of an emergency Cranko thyroidectomy
  84. in the picture, a surgical crack.
  85. A thyroidectomy is illustrated,
  86. you can see the advanced practice provider palpitating the crack,
  87. a thyroid membrane and then in the next step,
  88. taking a scalpel and making a single horizontal stab
  89. incision through the skin to expose the crack.
  90. A thyroid membrane using the scalpel blade as a guide.
  91. A tracheal hook is used to provide traction
  92. in the coddle direction to stabilize the trachea
  93. next and number four cuff tracheostomy tube or number six cuffed E. T.
  94. Tube is inserted through the opening and the airway is established
  95. in the white.
  96. The link for the youtube video is,
  97. it's a great video that describes a surgical creek oath.
  98. I rata me and illustrates it very well.
  99. Unfortunately I was unable to embed it in my presentation.
  100. Emergency creek oath Arata mies remained the principal
  101. method of airway rescue after failed intubation.
  102. They are commonly used in the military due to traumatic natures of
  103. their injuries and due to improved
  104. airway management techniques in video laryngoscope.
  105. E There is a decreased incidence in the requirement of cranks
  106. other complications that can occur from the insertion of
  107. an emergency craig Dorothy Rodham E include bleeding,
  108. lacerations of tracheal cartilage, perforation of the trachea,
  109. creation of a false tract infection.
  110. Subplot X. Stenosis and voice changes.
  111. However, despite these complications and emergency craig.
  112. Oh thoracotomy remains the final step between life and
  113. death for a patient with a difficult airway.
  114. The benefit in this case will always outweigh the risk if if it is successful.
  115. Here are my references that are listed. Thank you very much for listening.
  116. Please feel free to ask me any questions on the discussion board. Thank you, bye bye