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Cricothyrotomy vs.tracheostomy ?

Bob Waddell II bobwaddell at bresnan.net
Tue Apr 1 15:49:17 BST 2008

>From the view point of a Paramedic who worked in a system that allowed
surgical cric's in the field, they are a quick and effective procedure to
control an otherwise uncontrollable airway AND it leaves the tracheostomy
region clear for the surgeon, to the benefit of the patient needing extended
ventilatory support.  This is similar to the thought process of needle
decompressions in the anterior chest leaving the axilla region a virgin site
for surgical interventions being done in the hospital.  

Take care, 
(307) 920 - 2020 cell

bobwaddell at bresnan.net 

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Ronald Gross
Sent: Tuesday, April 01, 2008 8:02 AM
To: Trauma & Critical Care mailing list
Subject: Re: Cricothyrotomy vs.tracheostomy ?

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

>>> 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
Your most unhappy customers are your greatest source of learning. Bill

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or approaches perfomed in the way suggested in this note. 


----- 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

Mike Sise
San Diego, CA


From: trauma-list-bounces at trauma.org on behalf of
trauma-list-request at trauma.org 
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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