HALO Procedures

Question 1

Open Cricothyroidotomy

Answer 1

• Stand on R of patient
• Locate Cricothyroidmembrane
• Stabilise cartilages with thumb/middle finger of L hand.
• Utilise scalpel make vertical incision midline between cartilage (Skin & SC tissue).
• Horizontally perforate Cricothyroid membrane.
• Put finger then bougie through incision.
• Insert ETT (2-3cm) then secures.

Question 2

Needle Cricothyroidotomy (10 y.o)

Answer 2

• Stand on R of patient.
• Locate Cricothyroidmembrane
• Attach 5 ml syringe filled with water to 14G cannula
• Insert cannula into SC tissue at 90 deg, aspirate gently while advancing.
• When air aspirated, change to 45 deg (towards feet) & advance plastic.
  Withdraw needle & syringe.
• Withdraw plunger from syringe & attach catheter in neck, attach adaptor to open end.
• Attach O2 to adaptor & start ventilation at 100% O2.
• NPA/OPA placement will aid expiration.

Question 3

Jet Ventilation

Answer 3

I:E = 1:4
- Set O2 1L/min/year of age max 10L/min
- Placed O2 tubing, attach to syringe plunger.
- inflate 2-4s, watch chest rise & fall, remove tubing.
- observe for 20s for improvement in sats.
- When sats falls 5% from max, further inflate for 2s.