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Always carry your Scalpel

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Brian Burns gives you all the right reasons to carry a blade.

Go to www.intensivecarenetwork.com for the talk

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Always carry your Scalpel

  1. 1. Disclosures courtesy http://www.ranulphfiennes.co.uk
  2. 2. Always Carry Your Scalpel Brian Burns
  3. 3. Procedures Are sometimes performed infrequently by Fiona Reardon Life saving YOU MUST PREPARE FOR THESE PROCEDURES Cognitive hurdle
  4. 4. Surgical Airway courtesy jack milenius
  5. 5. Surgical Airway courtesy jack milenius
  6. 6. 6
  7. 7. SURGICAL AIRWAY is NOT a VISUAL procedure
  8. 8. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE
  9. 9. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE
  10. 10. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE INCISE
  11. 11. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE INCISE FEEL
  12. 12. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE INCISE FEEL BOUGIE
  13. 13. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE INCISE FEEL BOUGIE TUBE
  14. 14. SURGICAL AIRWAY is NOT a VISUAL procedure DECIDE LOCATE INCISE FEEL BOUGIE TUBE ETCO2
  15. 15. Surgical Airway - tips
  16. 16. Open thoracostomy
  17. 17. courtesy BMJ
  18. 18. Sight Saving Procedure
  19. 19. Lateral Canthotomy
  20. 20. Lateral canthotomy-tips
  21. 21. Escharotomy
  22. 22. Field Amputation
  23. 23. Field Amputation
  24. 24. Clamshell thoracotomy Indications Contraindications Clamshell Thoracotomy
  25. 25. Possible Outcomes….
  26. 26. courtesy London HEMS
  27. 27. Clamshell thoracotomy-TIPS courtesy London HEMS
  28. 28. Things to avoid….
  29. 29. Perimortem hysterotomy Cardiac arrest > 24 weeks gestation <5 minutes to deliver baby from cardiac arrests Takes 1 minute, hence start at 4 minutes after arrest
  30. 30. Perimortem hysterotomy Cardiac arrest > 24 weeks gestation <5 minutes to deliver baby from cardiac arrests Takes 1 minute, hence start at 4 minutes after arrest dogma ?
  31. 31. Perimortem hysterotomy Scalpel & Scissors
  32. 32. Perimortem hysterotomytips Umbilicus =20 w. 1 week/cm above that Don’t stop chest compressions Cut around the umbilicus
  33. 33. Things not cool with a scalpel cutting yourself during procedure cutting the pilot tube of an ETT instead of trachy tape NOT using it when indicated forgetting to bring your scalpel
  34. 34. Thank you !

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