Pediatric Neck Rescue Access Comparison

"1. The assistant places themselves with two preparation clamps at the head end of the table and assists with each hand placed lateral to the neck, so that the operating field is freely accessible. After the trachea or cricoid is palpated, a long median longitudinal skin incision of 2-3 cm is made from the cricoid caudally~2. The assistant uses straight clamps to pull the two edges of the skin incision apart dorso-laterally. In the event of major bleeding this maneuver should allow the blood to drain off dorsally and the view of the anatomical structures should be less impaired.~3. Layer by layer of the anatomical structures are cut through with the scalpel and tightened with the clamps accordingly.~4. Using a longitudinal incision, two to three tracheal rings are cut through distally to the cricoid~5. An 8 FR Frova catheter is inserted through the orifice into trachea.~6. A tracheal tube (ID 3.0 mm) is inserted over the Frova catheter to secure the airway permanently."

"1. Orientational palpation and vertical midline skin incision followed by separation of the strap muscles~2. Exposure of the trachea and cricoid followed by anterior luxation of the trachea with a Backhaus towel clamp~3. Perform a vertical puncture with a tip scissors between the cricoid and 1st tracheal ring followed by a vertical incision of no more than 2 rings in length.~4. A tracheal tube (inner diameter 3.0 mm, cuffed) is inserted to secure the airway permanently."