The North American Rescue tracheostomy airway with bougie introducer is demonstrated in a surgical airway. This an excerpt from our Complete Tactical Casualty Care course skills station.
From NAR’s website: “The North American Rescue Tracheostomy Kit with Bougie-Introducer is a convenient device that gives the user a pre-inserted bougie for introduction of the tube into the trachea and indication of correct placement prior to insertion. The bougie-introducer is adjustable for maximum user preference, and the excess can be tucked into the included cap that rests on top of the tracheostomy tube. Contains the same preferred flexible tube as NAR’s Tactical CricKit®. This latex free tube is sterile and has a 6.0mm inner diameter and an inflatable cuff.”
To use this device, you need to begin with the standard surgical airway:
- Prepare your equipment. This device comes out of the package very tightly twisted and requires some manipulation to straighten it out
- Locate the cricothyroid membrane.
- Establish positive position on the chin of the casualty
- Trace down the neck to find the Adams apple
- Continue marching your index finger downward and you will fall into a trench where the cricothryoid membrane is located
- Continue the march downward to ensure proper positioning, feeling the cricoid cartiledge, then tracheal rings,
- March back up to the established cricothyroid location
- Using a scalpel, cut through the soft tissue and cut down to the cricothyroid membrane making a vertical incision (parallel to the throat/neck)
- When you can visualize the cricothyroid membrane, pop through it with the scalpel and maintain positive control over the hole once established
- Insert the bougie into the surgical airway hole
- This should allow the tube to slide easily into the surgical airway
- Remove the bougie introducer to allow air to flow through the tube
- Secure the airway in place with the included straps
Interested in more? You can learn about surgical airways in our Complete Tactical Casulaty Care course.