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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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Monday, May 23, 2016

Chest Tube and Surgical Airway

PHARM Prehospital and Retrieval Medicine Blog In Memory of Dr John Hinds

PHARM - By ketaminh - May 3, 2015
"Life threatening, critical care emergencies requiring immediate resuscitative techniques. Sound familiar?
The dreaded Cannot Intubate, Cannot Ventilate
The dreaded Tension pneumothorax
Remarkably,similar strategies & techniques for both situations!

  1. Both time critical conditions and interventions
  2. Both require access to an anatomical space or lumen
  3. Both can be managed with needle ( temporarily) and/or scalpel ( definitively)
  4. With scalpel technique, gloved finger identification of correct anatomy is crucial to reliable performance, as demonstrated in this excellent video by Weingart and Strayer

Same principle with surgical airway. Use your finger to feel the anatomy and to be sure you are in the correct space. Leaving your finger insitu whilst passing bougie is a reliable method but as long as you have digitally confirmed prior to bougie passage, you can remove your finger, pass bougie, then re-insert your finger to check the bougie is in correct space.
The teaching point is use your gloved finger for both Chest tube and Surgical airway!"