Endotracheal Tubes

In case anyone was wondering, here are wikipedia’s instructions for how to perform a tracheotomy… Curvilinear skin incision along relaxed skin tension lines between sternal notch and cricoid cartilage. Midline blunt dissection down to the trachea (optional depending on technique). Insertion of 14-gauge plastic cannula and needle with fluid filled syringe attached into trachea. Aspiration of air confirms correct placement of the tip in the trachea. Removal of needle leaving cannula in place. Insertion of soft tipped guide wire into trachea through cannula. Removal of cannula leaving guide wire in place. Tracheal dilatation is now undertaken – different techniques do this in different ways. Ciaglia – the sequential insertion and removal of a series (usually 4-5) of increasing larger dilators over the wire into the trachea. Griggs – insertion of a specially designed pair of guide-wire forceps along the wire into the trachea and then are opened to complete the dilation in one step. Rhino – insertion of a single large tapered dilator over a plastic guidewire reinforcement. Frova Percutwist – insertion of a specially designed screw of increasing diameter which rotates to create the dilatation. Insert tracheostomy tube (with concomitant withdrawal of endotracheal tube), inflate cuff, secure with tape around neck or stay sutures. Connect ventilator tubing.