Disclosures

courtesy http://www.ranulphfiennes.co.uk

Always Carry Your ScalpelBrian Burns

Procedures

Are sometimes performed infrequently

Life saving

YOU MUST PREPARE FOR THESE PROCEDURES

Cognitive hurdle

by Fiona Reardon

Surgical Airway

courtesy jack milenius

Surgical Airway

courtesy jack milenius

6

SURGICAL AIRWAY is

NOT a VISUAL procedure

SURGICAL AIRWAY is

NOT a VISUAL procedure

DECIDE

SURGICAL AIRWAY is

NOT a VISUAL procedure

DECIDE

LOCATE

SURGICAL AIRWAY is

NOT a VISUAL procedure

DECIDE

LOCATE

INCISE

SURGICAL AIRWAY is

NOT a VISUAL procedure

DECIDE

LOCATE

INCISE

FEEL

SURGICAL AIRWAY is

NOT a VISUAL procedure

DECIDE

LOCATE

INCISE

FEEL

BOUGIE

SURGICAL AIRWAY is

NOT a VISUAL procedure

DECIDE

LOCATE

INCISE

FEEL

BOUGIE

TUBE

SURGICAL AIRWAY is

NOT a VISUAL procedure

DECIDE

LOCATE

INCISE

FEEL

BOUGIE

TUBE

ETCO2

Surgical Airway - tips

Open thoracostomy

courtesy BMJ

Sight Saving Procedure

Lateral Canthotomy

Lateral canthotomy-tips

Escharotomy

Field Amputation

Field Amputation

Clamshell thoracotomy

Indications

Contraindications

Clamshell Thoracotomy

Possible Outcomes….

courtesy London HEMS

Clamshell thoracotomy-TIPS

courtesy London HEMS

Things to avoid….

Perimortem hysterotomy

Cardiac arrest > 24 weeks gestation

<5 minutes to deliver baby from cardiac arrests

Takes 1 minute, hence start at 4 minutes after arrest

Perimortem hysterotomy

Cardiac arrest > 24 weeks gestation

<5 minutes to deliver baby from cardiac arrests

Takes 1 minute, hence start at 4 minutes after arrestdogma ?

Perimortem hysterotomy

Scalpel & Scissors

Perimortem hysterotomy-tips

Umbilicus =20 w. 1 week/cm above that

Don’t stop chest compressions

Cut around the umbilicus

Things not cool with a scalpel

cutting yourself during procedure

cutting the pilot tube of an ETT instead of trachy tape

NOT using it when indicated

forgetting to bring your scalpel

Thank you !