A construction worker met with an accident and pre-sented to the trauma centre when a heavy concrete block fell over his face. He was found to have severe maxillofacial and laryngeal injury. He was not able to open his mouth and, on examination, he is found to have multiple fractures and obstruction in nasopharynx as well as oropharynx. In order to maintain a patent airway, the following procedure was done for him. Which of the following options define the procedure correctly?
A. Submental endotracheal intubation
B. Emergency tracheostomy
D. Subcutaneous tracheostomy
Ans: C. Cricothyroidotomy
(Ref Scott-Brown’s 7/e p476; Bailey 27/e p749, 26/e p695)
- Given image – Cricothyroidotomy.
- Life-saving procedure performed in extreme circumstances intended to be a temporizing measure until a definitive airway can be established.
- Patient’s neck is extended and the area between the prominence of the thyroid cartilage and the cricoid cartilage below is palpated with the index, finger of the free hand.
- In emergency situation, a vertical skin incision is recommended with dissection rapidly carried down to the cricothyroid membrane.
- A 1-cm transverse incision is made through the membrane immediately above the cricoid cartilage and the scalpel twisted through a right angle to gain access to the airway.