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Dilational cricothyrotomy

Melker technique

  1. Prepare equipment
  2. Advance dilator into cricothyroidotomy tube
  3. Identify cricothyroid membrane
  4. Palpate membrane, stabilize cartilage and make a midline incision
  5. Attach cannula to syringe filled with saline and advance cannula through incision and cricothyroid membrane. Confirm entry into airway by aspirating air
  6. Remove syring and trocar and advance soft flexible end of guidewire through catheter until it is several centimetres into airway
  7. Remove cannula, leaving the guidewire in place
  8. Slide dilator-catheter unit over guidewire into airway. NB keep hold of part of the guidewire at all times. Do not advance the tip of dilator beyond the tip of guidewire.
  9. Remove dilator and guidewire together, leaving the airway catheter in place. Connect the catheter to an appropriate ventilatory device.

©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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