1. Sydney Clinical Skills and Simulation Centre Management of the Critically Obstructed Airway Session 5: Infraglottic Airway Rescue Practical Session

2. Plan  4 rounds x 30 minutes each  Workstations 1-3 Cannula cricothyroidotomy/jet oxygenation Melker TM Scalpel bougie  Groups move to different workstation  Workstation 4 All groups do same activity

3. Best attempt at supraglottic rescue? Oxygen saturations persistently low? Is this a CICO situation? DECLARE CICO CAN’T INTUBATE & CAN’T OXYGENATE (CICO) EMERGENCY PROTOCOL Resources 1. Cannula-cricothyroidotomy kit Jet oxygenation tubing Melker™ kit Self-inflating bag 2. Scalpel – bougie kit 3. Scalpel – finger – cannula kit 4. Arrest trolley NO Continue supraglottic rescue Consider waking patient Review again in 1 min With permission A. Heard and Working group for the Rural Health Continuing Education (RHCE) (Stream 1) ‘Critically Obstructed Airway Workshop’. Contact: smsc@nsccahs.health.nsw.gov.au. 2013.smsc@nsccahs.health.nsw.gov.au SUPRAGLOTTIC RESCUE – MOBILISE RESOURCES FOR CICO INFRAGLOTTIC RESCUE Team roles ALGORITHM 1.Teamleader 2.Proceduralist – infraglottic rescue 3.Proceduralist – supraglotic rescue 4.Assistant – supraglotic rescue 5.Assistant – infraglottic rescue 6.Assistant – equipment set up 7.Scribe Algorithm Mobilise resources for CICO YES Face mask ventilation LMA ventilation Endotracheal intubation