Cricothyroidotomy

1. Position patient on head ring and sandbag between shoulder blades.
2. Prep and drape.
3. Grasp the thyroid cartilage between the thumb and middle finger of left hand and palpate the cricothyroid membrane with the index finger.
4. Make a transverse incision at this level about 2cm in length after infiltrating with LA through skin, fascia and cricothyroid membrane.
5. Insert curved Mayo scissors into the opening and spread to enlarge.
6. Insert a cuffed Tracheostomy tube Size 8 (8mm internal diameter) into the lumen and secure as above. No need to close the wound.