How to Perform a Tracheotomy

What happens if a Heimlich maneuver doesn’t work? What if somebody is choking right in front of you, not breathing at all, on the verge of asphyxiation because of a throat obstruction? You need to get air into this person’s lungs. In this most extreme of emergencies, you might have to perform a tracheotomy.

Difficulty: Moderately Challenging

Instructions

Things You'll Need:

• Razor blade, scalpel or sharp knife
• Straw or tube from stick pen, refill removed
• A cardboard tube could work as well
• First aid kit if available
• Rubber gloves

1. Perform the Heimlich maneuver at least three times before proceeding: That is, grab the victim securely around the back with your arms below the rib cage and around the abdomen. Pull up sharply four or five times. You’re effectively creating an artificial cough designed to expel an obstruction from an airway. Slap the victim on her back.

2. If it doesn’t work, have somebody there call a paramedic, and somebody else start counting down the minutes. This entire procedure has to be completed within three minutes before brain death sets in.

3. Reassure the victim. Panic can make the situation worse. Keep a cool head. Deep breathing helps me in an emergency. By now the victim is probably about to pass out from lack of oxygen. Unconsciousness will make your work easier.

4. If you have them available, snap on rubber gloves. If you can sterilize your tools with alcohol or iodine from a first aid kit, do so. If a kit is not handy, don’t bother. Infection is a concern, but death looms larger. The clock is ticking.

5. Extend the victim’s neck. Between the Adam’s apple and a ridge known as the Cricoid cartilage, you’ll find a small soft spot. If you have iodine, mark the area. You’ll be cutting here.

6. Use one hand to tighten the skin. Pick up your knife of scalpel. Make a half inch left to right incision about a half inch deep. Just below your cut, you’ll see the cricothyroid membrane. Make an incision on the membrane itself. Enlarge it by inserting the end of your scalpel, a finger, or even pinching it.

7. Insert the tube to the depth of a half inch to an inch. With luck the victim will start breathing on his own. If not, you’ll have to administer Cardiopulmonary Resuscitation (CPR) through the tube itself. If the heart rate drops below 40 beats a second, you’ll have to give chest compression as well.

8. As soon as possible, get the victim to emergency care.

Tips & Warnings

• This procedure will only work if the obstruction is above the level of the Adam’s apple.
• This procedure should only be performed when no other options exist in a matter of life and death.
• You face a legal minefield here. If the victim dies, the family can blame you for his death and sue. If the victim lives, she could sue you for assault.
• You could do it wrong: If you miss, you could nick a vocal cord, changing how victim speaks, or sever an artery causing an end to the very life you’re trying to save.

[Checkpix]

on 9/24/2008 Laws vary state by state. I'm simply stating that this a way to save somebody's life. If you mess up you could be held liable.

[Pilot1977]

on 9/23/2008 I am a First Responder (not an emt). So, are you saying with the tips and warnings you dont recommend this at all. Do the Good Samaritan laws not apply in doing this.