MISSION ESSENTIAL ™ EQUIPMENT

S.A.S.

™ SURGICAL AIRWAY SET

S.A.S.™

STERILE - PRODUCT#: 40309 NSN#: 6515-CF-002-7744 TRAINING ONLY/NON-STERILE - PRODUCT#: 40305

SURGICAL AIRWAY SET

NSN#: 6515-CF-002-7745

IMPORTANT: Follow your Medical Director’s approved protocols and procedures. Do not use this kit if not trained or authorized to perform an emergency cricothyroidotomy. Proper training in the use of the kit is essential prior to using it in a real world emergency. Reading these instructions does not constitute proper training in this kit. These instructions are not comprehensive nor a replacement for adequate training.

SUGGESTED INSTRUCTIONS FOR USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. Identify the requirement for an emergency cricothyroidotomy as per your approved protocol. Open the kit and utilize the wrapping paper as a clean field. Don gloves. Empty contents of plastic bag onto wrapping paper and verify kit contents. Clean the skin around and below the cricothyriod cartilage with the chlorhexidine swab using aseptic technique. Remove the safety tape from the scalpel. Stabilize the trachea with the thumb and middle finger of your non-dominant hand. Unguard the scalpel with the thumb of your dominant hand. Identify the notch between the cricoid and thyroid cartilage and make a vertical (parallel with the axis of the body) incision with the scalpel, centered over the cricothyroid membrane, through the soft tissue, down to the trachea, approximately 1.5” long. DO NOT CUT CARTILAGE. See Figure: 1, 2, and 3.

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Figure: 1

Figure: 2

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Figure: 3 10. Insert your index finger of your non-dominant hand into the incision to confirm the location of the cricothyroid membrane. Place your finger superior to the membrane, on the cartilage prominence. See Figure: 4.

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Figure: 4

11. Using your finger as a guide to the landmark, insert the scalpel into the incision in a horizontal orientation (perpendicular to the axis of the body) and puncture the cricothyroid membrane large enough to pass the tube. You should immediately hear air movement though the puncture hole if the casualty is making respiratory effort. DO NOT PUNCTURE THROUGH THE BACK OF THE TRACHEA. See Figure: 5.

Figure: 5 12. Lean the side of the scalpel blade against the cartilage prominence, maintaining it in the punctured hole, and insert the small sharp hook end of the Tracheal Hook into the hole, using the scalpel as a guide, all the way to the back of the trachea. See Figure: 6.

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Figure: 6 13. Rotate the hook 90° towards the feet. 14. Hook the trachea at the inferior aspect of the hole and provide traction straight up. If done correctly, this should open the hole you have created in the trachea enough to allow passage of the Tracheal Tube. 15. Remove the scalpel from the hole and slide the guard over the blade. See Figure: 7, and 8.

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Figure: 7

Figure: 8 16. Maintaining traction on the trachea with the hook, insert the Tracheal Tube directing it inferior, toward the lungs. See Figure: 9, and 10.

Figure: 9

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Figure: 10 17. Lean the Tracheal Hook inferior and remove. See Figure: 11.

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Figure: 11

18. Pull down the side wings of the Tracheal Tube and remove the stylette from the tube. See Figure: 12, 13, and 14.

Figure: 12

Figure: 13

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Figure: 14 19. Look, listen and feel for air passage through the tube. Confirm tube placement. 20. If tube is in the correct location, inflate the cuff on the Tracheal Tube using the syringe. Only inflate with as much air as required to apply gentle pressure. DO NOT OVER INFLATE. Remove the syringe from the Tracheal Tube. See Figure: 15.

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Figure: 15

21. Slide the Serpent Hook under the patient’s neck and secure to the Tracheal Tube through the holes on the wings on both sides. Tighten the Serpent Hook enough to prevent tube displacement but not so tight as to restrict circulation. 22. Reassess tube placement and respirations. 23. Document all care provided.

TROUBLESHOOTING: If the tube is not patent with respiration or ventilation, conduct the following troubleshooting steps. Consider that the tube may be in the correct place and the patient may be in respiratory arrest - attempt to ventilate with BVM. If no air passage: a. With your index finger, circumnavigate the tube at the point it enters the cricothyroid membrane, feeling that the tube is inside the trachea. You should not be able to feel the tube in the pre-tracheal plane. If the tube is not in the trachea, remove it and start the procedure again. If it is in the correct position; Connect the syringe to the pilot bulb of the Trach Tube and deflate the bulb. There is a slight possibility the bulb may have been overinflated causing it to deform, obstructing the distal end of the Trach Tube. If no air passage through the Trach Tube; Remove the Trach Tube, reset equipment and start over.

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NOTES

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NOTES

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