Never done a surgical Airway in an Adult live patient. Only manikins and cadavers so far. Have only intubated a live pediatric patient in a patient in respiratory failure from Croup. Definitely haven't done a surgical airway in a child or infant yet. It doesn't stop me from practicing and preparing for this rare clinical case. Don't just stand there and watch the natural course of death from failing to oxygenate this patient.
Prepare and perform.
Thank you JM SeaTurtle for your enthusiasm in performing possible surgical options in an infant in the CICO scenario.
Here is the link to the future...
or doing a tracheostomy. The former more likely to happen than the latter. Look up the VENTRAIN + CRICATH = RESCUE VENTILATION W/O PREVENTING ASPIRATION blog.
First video working on a Laerdal SimBaby....taking a 14 gauge needle catheter and seeing if a 3 cc syringe with 7.0 endotracheal tube adapter will succeed in ventilating the manikin. But you will notice the catheter kink so well and perform so poorly.
Second video on the same manikin. I used the BenTaub Houston method taught to me by one of my prior Program alumni Malia Myers. Cut the same IV adapter we use on Normal Saline or Lactate Ringer' Solution for our patients. But don't cut too low or too high. Just right and the connection to any regular Bag Ventilator Mask will fit. That distal tip is very sharp and will stay patient. No flimsy plastic. That won't kink for real.
Third video. Same Manikin. If the catheter when the needle is removed becomes so delicate and so easy to kink, why not keep the needle in temporarily to see if the same 3cc syringe connector demonstrated above would work now. NOPE.
I am limited on manikins who will perform the way I want them to perform. Not many pediatric manikins exist to practice surgical airways. Need to make one or find one to remedy this problem.