I'm going to watch this again for emergency purposes, but i wont feel confident until I practice on something dead already. Anyone have a stockpile of corpses for me to work on?

@jiggahjonson

It doesn't have to be dead, it can be inanimate I'm sure there are dummies made for this sort of thing.

Doing this sort of thing without having some sort of training is not only dangerous, but also very dicey when it comes to civil courts. You know... that whole litigation bit.

What I really mean to say, is exactly what this video should have said, "Never perform this unless you are a medical professional/First Responder."

In short, you fuck up and hit one of the carotid branches or the common carotid and it's "good night sweet prince."

Not the best citation website, but it seemed to have the best description of Exsanguination.
http://www.thenakedscientists.com/HTML/content/latest-questions/question/2103/

Moving this video to grinter's personal queue. It failed to receive enough votes to get sifted up to the front page within 2 days.

*promote

Self promoting this video and sending it back into the queue for one more try; last queued - promote requested by original submitter grinter.

In what situation would I need to do this?

That would be helpful. Apart from "for fun".

Felt like I was watching that episode of MASH when Mulcahey does this

This strikes me as a bullshit video made by ghouls offering no practical emergency medical advice. There may be technical expertise demonstrated in a controlled environment, but no practical advice can be gained from this. Instead, showmanship is displayed. Please, don't try to stun us with information, but instead inform us of every-day useful advice please. I appreciate your efforts truly, but this display of your bravura during a clinical, carnal display does not truly help anyone. Please continue with your medical studies, but do not suppose us fools easily impressed with a supposed dire situation. Imagine us and wonder what the fuck we are suppose to walk away from this with other than being impressed with your calm tone.

I have had one since I was born.

*howto

Adding video to channels (Howto) - requested by ant.

Airways are my business. In one review of 50 prehospital surgical airways (performed by paramedics in the Phoenix area), only 2 had meaningful neurologic function on discharge from the hospital. A "save" from a pre-hospital surgical airway is a rare event.

>> ^snoozedoctor:

Airways are my business. In one review of 50 prehospital surgical airways (performed by paramedics in the Phoenix area), only 2 had meaningful neurologic function on discharge from the hospital. A "save" from a pre-hospital surgical airway is a rare event.

I'm not arguing for the procedure, nor am I qualified to, but some clarification would be helpful:


Presumably, paramedics in the Phoenix area have a range of airway management tools available, including intubation. How do you think that influences the rate of successful/useful cricothyrotomies reported in the study you mentioned?
Also, what do you mean by "meaningful neurologic function on discharge from the hospital"? Do you mean "alive"?
2 of 50 lives saved in a sample where other tools were available and the surgical procedure was used only in the most dire circumstances doesn't sound like a bad ratio to me.

In emergent airway algorithms, cricothyrotomy is the choice of last resort, so paramedics would have exhausted all other options. One other study, I can't remember where it was done, found that over half of the surgical airways that had been performed in the field were unsatisfactory airways on presentation to the ER, i.e. only around half were actually successful. I don't think anyone can fault someone for following suggested algorithms. As an old and wise surgeon once told me, "son, you can't get much deader than dead." The statistics merely point to the dismal prognosis, should one be required. "Meaningful neurologic outcome" just means there wasn't a severe brain injury, such that the patient could have some quality of life.

I went back and reviewed the abstract from the Phoenix study. My numbers were a little off, 56 patients received a surgical airway, 27% survived to discharge from the hospital, but only 3 were judged to have "good neurologic recovery."

snoozedoc eh..... I've met your type son.... but only for a minute or two and then i get real sleepy

>> ^doogle:

In what situation would I need to do this?
That would be helpful. Apart from "for fun".


Watch the video again, from the beginning, where it says "Indications." What follows is a list of situations in which this procedure is "indicated" (or "prescribed," or whatever layman's term for "you only do this when this situation occurs.") I can break them down for ya.

If you are ever in a situation where you find someone unconsious, with a pulse, but no signs breathing, you need to establish why they are not breathing. There are training videos and classes on this sort of thing, and I highly recommend everyone not only do so, but stay on top of new data and findings. Even just recently CPR guidelines have changed - mouth-to-mouth is only really necessary for drowning victims. Cardiac arrest is usually the cause of most instantaneous medical emergencies, and keeping steady chest compression rhythm to manually pump the heart is more important to saving the brain and oxygen-dependent tissues M2M breaths should only be administered once or twice every 30 compressions or so.

Anyway, to break things down:

"Severe Maxilofacial trauma" Nasty wounds to the jaw and mouth that prevent mouth-to-mouth or mouth-to-airbag contact.

"Severe Bleeding to the airway/oropharynx" Just another big word for hole on everyone's face that is their mouth extending back into their vocal chords. Blood and/or clotting is preventing breathing. CPR would force blood into the lungs in a bad way.

"Foreign matter in upper airway" They've got something lodged in their throat, far enough in that you can simply pull it out with your fingers, or you can't get them to a position to "heimlich" them (not that we use the Heimlich maneuver anymore - there's a similar, more modern-science-informed method).

"Edema secondary to burns to the face and airway" Edema is another word for swelling. Again, you can't mouth-to-mouth or to-airbag over burn wounds, and sometimes your throat can swell shut from burns, be they burns from fire or chemical.

The last couple should be self-explanitory.

What then follows are a list of "Contraindications" or situations in which you should AVOID this procedure. In medicine, these are important. For example, massaging someone's swollen legs after they just landed from an airplane flight is contraindicated, as leg swelling is a sign on deep-vein thrombosis. Failure to identify and accommodate contraindications will could lead to patient death exposing you to legal and civil liability. And the guilt of knowing you killed someone you were trying to help.

I'm not a doctor. I'm just a certified massage therapist with over 600 hours of training in massage-oriented anatomy, physiology, pathology and ethics, among other important lessons. I have no authority to make diagnoses.. But my massage school gave me enough information to know when I could potentially harm someone, and how to identify those situations should they arise in my practice.

>> ^doogle:

In what situation would I need to do this?
That would be helpful. Apart from "for fun".
Summing up kagenin's excellent post above. Tracheotomy is for when there is complete physical obstruction of the upper airway (be it due to a wound, swelling, or a foreign object) and less drastic methods of opening the airway or getting oxygen into the lungs (e.g. Heimlich or rescue breaths) are either impossible, unavailable, or have failed.