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Tue Apr 1 15:02:10 BST 2008

In my opinion, a cric is the only option in this scenario..........

Ron
>>> Ivan Hronek <ivanhronek at yahoo.com> 4/1/2008 9:55 AM >>>
Cricothyrotomy vs. tracheostomy in a failure to intubate/failure to ventilate anoxic patient:
It appears some surgeons are more comfortable to go for a tracheostomy as this is what they do more often.
Cricothyrotomy is expected to be a much quicker way to obtain an airway.

What are your views and experiences on this dilemma ?

Ivan Hronek MD 
SFMC, Los Angeles
cell: 310 487-3288
http://health.groups.yahoo.com/group/Anesthideas/ 
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----- Original Message ----
From: "Sise, Mike MD" <Sise.Mike at scrippshealth.org>
To: trauma-list at trauma.org 
Sent: Tuesday, April 1, 2008 6:29:27 AM
Subject: RE: trauma-list Digest, Vol 58, Issue 1

A question for the trauma.org-istas:

You've completed a brilliantly conceived and daring executed trauma laparotomy in an obese (5 ft 10 in - 250 lbs) hypotensive patient following a motor vehicle crash who required significant resuscitative efforts (1:1 transfusions with a spritzer of normal saline) and is now a bit cold 95F (35C) and you packed the liver which was mildly wet and you placed a drain over a contused by not lacerated mid portion of the pancreas. The patent is hemodynamically stable and you plan a return in 24 to 48 hours depending on his status. There are not bowel anastamoses to perform. There are not other associated injuries.

How to you do your damage control closure: specific details please - do you do anything to prevent recession of the abdominal wall - i.e., sutures approximating the edges or other measures. What is you ventilation and sedation strategy with the open, damage controlled abdomen. Please add any other thoughts you find valuable.

This is an area of much creativity (variation) and we need to share our thoughts.

Mike Sise
San Diego, CA

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Sent: Tue 4/1/2008 4:00 AM
To: trauma-list at trauma.org 
Subject: trauma-list Digest, Vol 58, Issue 1

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Cricothyrotomy vs.tracheostomy ?