But stand on your dominant side not at the head side ,you can control this procedure better ,you can anchor your hand on pt chest . Scalpel, finger bougie and tube Now no more hooks or tracheal dialator. Finger is a good dialator and blood is good lubricant and if one can feel posterior tracheal rings then straight go for tube as it's a peri arrest situation
Why not insert a tube exchanger or bougie once you have access to the trachea? It seems like this will make placing the tube much easier. For that matter, why not access the trachea as you would if you were placing central line? Advance needle under negative pressure aspiration and then wait for air to come back the same way you would wait for blood return when placing central line. Cannulate with IV, thread wire through cannula, then cut where the wire is down to trachea. THEN put tube exchanger over wire, THEN put tube or trach over tube exchanger. It seems like this would be much easier for someone who has done very few of these... which will be almost everyone watching this video. It leverages skills that most providers are already likely to have from placing lines. Would be interested in your feedback on this approach.
Im super obsessed with all your videos now. lol
Amazing demonstration!!! 😀
I think inserting a Boogie instead of the hook and seldinger it inside seems much more comfortable for me.
Thnx and cheers from Sweden!
Thank you so much
But stand on your dominant side not at the head side ,you can control this procedure better ,you can anchor your hand on pt chest . Scalpel, finger bougie and tube
Now no more hooks or tracheal dialator.
Finger is a good dialator and blood is good lubricant and if one can feel posterior tracheal rings then straight go for tube as it's a peri arrest situation
Nice.
Why not insert a tube exchanger or bougie once you have access to the trachea? It seems like this will make placing the tube much easier.
For that matter, why not access the trachea as you would if you were placing central line? Advance needle under negative pressure aspiration and then wait for air to come back the same way you would wait for blood return when placing central line. Cannulate with IV, thread wire through cannula, then cut where the wire is down to trachea. THEN put tube exchanger over wire, THEN put tube or trach over tube exchanger.
It seems like this would be much easier for someone who has done very few of these... which will be almost everyone watching this video. It leverages skills that most providers are already likely to have from placing lines.
Would be interested in your feedback on this approach.
covered this extensively in the needle vs. knife episode as well as the interview with Laura Duggan
Would love to see a demonstration when it involves a 350lb+ patient.
Little rough don't you think
I kneel to your videos, Master