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Resume Of Emergency Tracheotomy

Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

The following notes should be memorized.
1. Essentials: Knife and pair of hands (but full equipment better).
[295] 2. Don't do a laryngotomy, or stabbing.
3. Two stage, finger guided operation better.
4. Sand bag or substitute.
5. Press back danger lines with left thumb and middle finger, making
safety line and trachea prominent.
6. Memorize Jackson's tracheotomic triangle.
7. Incise exactly in middle line from Adam's apple to sternum.
8. Feel for tracheal corrugations with left index in pool of blood,
following trachea with finger downward from superficial Adam's apple.
9. Pass knife along index and incise trachea (not too deeply, may
cut posterior wall).
10. Don't mind bleeding; but keep middle line and keep head
straight; keep head low; don't bother about thyroid gland.
11. Don't expect hiss when trachea is cut if patient has stopped
12. Start artificial respiration.
13. Amyl nitrite. Oxygen.
14. Practice palpation of the neck until the tracheal landmarks are
15. Practice above technic, up to point of incision, at every
16. Jackson's tracheotomic triangle: A triangulation of the front
of the neck intended to facilitate a proper emergency tracheotomy.
Apex at suprasternal notch.
Sides anterior edge sternomastoids.
Base horizontal line lower edge cricoid.

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