Practical Plan for a Needle Cric!

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Picture of Steve Haywood
Steve Haywood
Former Respiratory Therapist working to de-mystify the ventilator through hands-on workshops and online education. Additional interests include HFNC in CHF and COPD, Medical Education, and Tupperware.
Picture of Caleb Harrell
Caleb Harrell

Emergency Medicine by day, Critical Care by night. Trained at The University of Tennessee and The University of Florida. Hobbies include hiking, biking, liking, and pyrex portables.

The Pre-brief

When a pediatric patient needs an emergency needle cricothyrotomy, it is not a time to learn your equipment. You need an angiocath that you can connect a syringe while the needle is still in place. You also need some way to connect an oxygen delivery device to this angiocath. Instead of rummaging through equipment trying to find all of the necessary items, just grab these 3 itmes.

1. A 7.0 ETT

2. A central line kit

3. A Bag-Valve device

We will show you how to put them together to provide oxygen to a patient 

References

  1. Remove the plunger from the 3mL syringe found in a CVC kit.
  2. Shove the small end of the BVM connection off of a 7-0 ETT into the 3mL syringe where the plunger was inserted. 
  3. Utilize the needle with angiocath that comes in the CVC kit to assure you can continuously aspirate while you advance the needle. 
  4. This procedure is not definitive. It does not provide any ventilation. You still need to secure a definitive airway. 
  5. Anesthesia, ENT, and General Surgery can all assist. The foreign body either needs to be removed or a surgical airway must be obtained. 

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