Question

Describe the steps of the bougie assisted cricothyrotomy

Answer 1

A bougie-assisted cricothyrotomy is an emergency procedure carried out to establish an airway when other methods are impossible. It involves making an incision in the cricothyroid membrane and inserting a bougie to guide a cuffed tracheal tube into the trachea.

Step-by-step explanation:

The bougie-assisted cricothyrotomy is an emergency procedure used when conventional intubation techniques are not possible. It is often performed in cases of severe airway obstruction when other methods fail or are contraindicated. Here are the basic steps typically involved in this procedure:

1. Identify the cricothyroid membrane which is located between the thyroid and cricoid cartilage on the anterior neck.
2. Administer local anesthesia to the area if the patient is conscious and time permits.
3. Make an incision longitudinally over the cricothyroid membrane.
4. Stabilize the larynx with one hand and use the other to enlarge the incision to allow insertion of the bougie.
5. Insert the bougie into the incision, directing it caudally into the trachea.
6. Remove any tissues or blood clots that may obscure the opening before inserting the bougie to avoid creating a false passage.
7. Once the bougie is in place, thread a cuffed tracheal tube over it and into the trachea.
8. Hold the tube in place while removing the bougie carefully.
9. Secure the tube, confirm placement with end-tidal CO2 detection, chest rise, and breath sounds.
10. Begin ventilation and proceed with post-procedure care.

Due to the critical nature of this emergency procedure, it is imperative that it be performed by trained medical professionals with appropriate skills and experience in airway management.