4. +
Technique – Scalpel/bougie
Palpable membrane
Transverse stab
Turn blade through 900
Slide bougie coude tip along blade
into trachea
Railroad 6mm ETT into trachea
Ventilate inflate cuff and confirm
position
Secure tube
5. +
Technique – Scalpel/bougie
Impalpable membrane
8-10cm vertical incision caudad to
cephalad
Blunt dissection with fingers to separate
tissues
Identify and stabilise the larynx
Proceed with technique for palpable
anatomy
6. +
Technique - Needle
Equipment
14G cannula
5 mL syringe
Water/Saline
Source of O2 – Jet/rapid O2/Macgyver
Laryngeal handshake
Insert cannula at 450 while aspirating
Advance cannula off trocar
Remove trocar
Reattach syringe to confirm aspiration
Supply O2 and secure cannula
Plan for conversion – Melker or other kit