Emergency Surgical Airway By Weingart

Performing an emergency surgical airway is one of the most challenging skills for any critical care doctor. It is a skill usually reserved for the most unstable, rapidly deteriorating patients and is a last resort for obtaining a patent airway. This is complicated by the fact that few people practice this skill frequently enough to feel comfortable performing it in an emergency setting. Emergency surgical airways are also challenging due to the anatomy of blood vessels and nerves surrounding the cricothyroid membrane and the associated high risk of injury to other structures.
In this video, EmCrit’s Scott Weingart (@emcrit) demonstrates his tactile technique for establishing an emergency surgical airway. One of the biggest issues people face is poor visibility due to the bleeding that inevitably occurs following the initiial incision. In this simple, step-by-step guide Scott Weingart outlines how to overcome this by feeling for important landmarks and modifying technique to ensure a successful procedure every time. As participants each practice this technique Scott Weingart offers troubleshooting tips to help manage even the most difficult airway. If you have any other tips, please share them below!

[@MrMiningsolutions]

If you are not, you definitely should have been a teacher, of everything and anything, I know for sure I would've liked you to be my teacher! Wonderful, your talent to get points across so we can understand and even feel things through is great! Thank you!

[@johnbaugh2437]

I did 3 crics in my career and two of them in 2017. I used this technique. Easy Peasy. No desats below upper 70’s and good outcomes.

[@jacob476]

I don't get it he said use the hand thats the same side as the patient...He's on the patient's right side, but uses his left hand

[@S1lentBob]

He meant using the right hand to make the cut

[@Sarah.Riedel]

"Now at this point you can't screw this up..."
BRO YOU'RE SLICING THE GUY'S WINDPIPE OPEN WITH A SCALPEL

[@wholeNwon]

In my experience (40+ years), people tend to reach for a scalpel too quickly. Obviously, if you are the only one available to save a pt., one must use what he knows. However I would emphasize that the student acquire a very high level of technical skill at endotracheal intubation. I have thus established airways very quickly certainly more than 1000 times and have had to use surgical approaches exceptionally rarely. I would also add that people often rush to intubation when the pt. can be ventilated very well with nothing more than an oral airway, mask and bag. This is decidedly preferable when possible as overall evaluation proceeds.

[@K1kuch1]

wholeNwon you are right,

[@wholeNwon]

@@K1kuch1 Thanks.

[@XthermomanX]

Nice & cheap training model! a balloon, some skincolored tape... what is the fake-trachea made of, to support the cutting sensation??

[@DuumaZ]

Thank you for this video!

[@kazuki_setsunai103]

I’m watching this since my sister has bad allergies and she has to get sent to the hospital twice because she couldn’t breathe well. But oh no I’m not doing this not to my sis I can’t imagine the pain she’ll be in if I cut her throat if she can’t breathe again I would probably faint or something if I saw any blood

[@MW-lr4kr]

This is NOT for bystander use. It is a procedure that should be carried out by high-trained good equipped clinicians in a clinical or pre-clinical setting.

[@shanek6582]

Once the tube is in there, does the patient just start breathing through that tube or do you have to hook up an air bag to it?

[@S1lentBob]

You only use this technique if the patient can't be intubated regularly or properly oxygenated using an Ambu bag. Which practically translates to: If you have to use this technique, the patient is probably not oxygenated very well, so you should immediately start ventilating.