The Emergency Tracheotomy: Something Everyone Should Know…Just in Case.

17 Aug

How to Perform an Emergency Tracheotomy

This procedure, technically called a cricothyroidotomy, should be undertaken only when a person with a throat obstruction is not able to breathe at all-no gasping sounds, no coughing-and only after you have attempted to perform the Heimlich maneuver three times without dislodging the obstruction. If possible, someone should call for paramedics while you proceed.

What you will need

  • A first aid kit, if available
  • A razor blade or very sharp knife
  • A straw (two would be better) or a ballpoint pen with the inside (ink-filled tube) removed.  If neither a straw nor a pen is available, use stiff paper or cardboard rolled into a tube. Good first aid kits may contain “trache” tubes.

There will not be time for sterilization of your tools, so do not bother; infection is the least of your worries at this point.


Emergency  Find the indentation between the Adam’s apple and the Cricoid cartilage.
Make a half-inch horizontal incision about one half inch deep.
Pinch the incision or insert your finger inside the slit to open it.
Insert your tube into the incision, roughly one-half to one inch deep.

How to Proceed

  1. Find the person’s Adam’s apple (thyroid cartilage).
  2. Move your finger about one inch down the neck until you feel another bulge.  This is the cricoid cartilage. The indentation between the two is the cricothyroid membrane, where the incision will be made.
  3. Take the razor blade or knife and make a half-inch horizontal incision.  The cut should be about half an inch deep. There should not be too much blood.
  4. Pinch the incision open or place your finger inside the slit to open it.
  5. Insert your tube in the incision, roughly one-half to one inch deep.
  6. Breathe into the tube with two quick breaths.  Pause five seconds, then give one breath every five seconds.
  7. You will see the chest rise and the person should regain consciousness if you have performed the procedure correctly.  The person should be able to breathe on their own, albeit with some difficulty, until help arrives.

Source:  The Worst-Case Scenario Survival Handbook by Joshua Piven and David Borgenicht

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