EMERGENCY TRACHEOTOMY

A tracheotomy is the formation of an opening into the trachea generally performed under medical supervision when obstruction to breathing has occurred because of trauma to the trachea or mouth above the level of the Adam’s apple. In an emergency situation where medical help is not available and an individual is not breathing because of obstruction, it may be necessary to undergo the following emergency procedures.

This technique should only be employed in exceptional circumstances. Other options, such as the Heimlich manoeuvre, must have failed and medical personnel not present before this procedure is considered. The individual must be completely unable to breath as shown by no movement of the chest, blueness around the lips or cardiac arrest.

Ensure that someone has called the ambulance or emergency service.

Obtain a tube, such as the outer casing of a pen, and a sharp instrument.

Lie the patient flat on the floor and extend the neck by tipping the chin backwards.

Locate the Adam’s apple and below the prominent notch there will be a noticeable dip, approximately half-inch wide in an adult.

Whilst applying adequate pressure, insert the sharp object through this cricothyroid membrane horizontally and, once through the thickened membrane and into the trachea, turn the object vertically.

There may be a surprising amount of blood.

As swiftly as possible insert the tube in the gap either side of the sharp object and, when in place, remove the sharp object.

Bubbling should be heard as air enters the lungs through the tube and also through the inevitable blood in the trachea.

If this is not heard ensure that respiration is taking place and commence artificial respiration using the tube instead of the mouth.

Attempt to stem any bleeding with gentle pressure.

Clean the area as well as possible and tape the tube into place.

Breathe into the tube if artificial respiration is needed.

Transport the individual to a medical centre as soon as possible.

RECOMMENDATIONS

Do not perform a tracheotomy unless it is absolutely essential, and this should be based

In an emergency tracheotomy, as described in the recommendations above, a tube is inserted into the trachea to allow breathing. This procedure should only be carried out when absolutely essential. on the fact that there is no respiration despite attempts at mouth-to-mouth resuscitation.

Do not perform a tracheotomy unless you are certain that medical intervention is not forthcoming.

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