03 Melker Insertion

Insertion Of Melker following Successful Cannula insertion and oxygenation
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[@robmccrossin8555]

Hi , excellent videos. Part of the seldinger technique is stabilising the wire proximally before advancing the device along the "stationary ' wire. This is to avoid kinking the wire and creating a new or false passage not in the lumen of the trachea and subsequent subcutaneous emphysema distorting the anatomy.. In one of your sequences the proximal end of the wire completely disappears into the Melker . This could also lead to a lost wire into the airway. Either complication can have serious results. Maybe this could be mentioned if the video is updated.

[@gregorymiller6026]

Nice tips. In the event the IV cannula is reinserted to salvage a difficult or prolonged placement, would you endorse re-aspirating with a fluid-filled syringe to confirm tracheal placment prior to jet ventilation?
Since shaking can be present in a high-stress situation, I have adopted as my routiune practice for all guidewires to oppose the hypothenar eminences to stabilize each hand relative to the other. With the wire grasped between the thumb and index finger of one hand and dilator between the thumb and index finger of the other, there is better control for threading the guidewire into the tiny orifice of a dilator. With this device it would then be necessary to regrip the base of the device to hold the dilator in place.