Needle cricothyrotomy

Essential Equipment

Antiseptic14 gauge IV catheter3.0 ETT adaptor OR 3 mL syringe with 7.0 ETT adaptor Bag-valve mask

Steps

  1. Position yourself at the head of the bed.

  2. Extend the patient’s neck

  3. Prepare the anterior neck with antiseptic.

  4. Stabilize the larynx and locate the cricothyroid membrane with your non-dominant hand.

  5. Attach a 14-gauge IV catheter to an empty syringe.

  6. Insert the needle at a 30-45 degree angle caudally through the skin, subcutaneous tissue, and cricothyroid membrane.

  7. Aspirate the syringe as you advance. Aspiration of air will be observed when the trachea is entered.

  8. Advance the catheter over the needle until the hub is flush with the skin.

  9. Remove the needle.

  10. Attach appropriate adaptors - either a 7.0 ETT adaptor attached to a 3 mL syringe or a 3.0 ETT adaptor attached directly to the catheter.

  11. Connect to a bag-valve mask and begin ventilation.

  12. Maintain control of catheter hub with hand until secured. Ensure it does not kink.

  13. Continue efforts to obtain definitive airway.