sas™ kit pog

7/29/2019 SAS Kit POG

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MISSIONESSENTIALEQUIPMENT

S.A.S.SURGICAL AIRWAY SET


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IMPORTANT:

Follow your Medical Directors approved protocols and procedures.

Do not use this kit i not trained or authorized to perorm an

emergency cricothyroidotomy.

Proper training in the use o the kit is essential prior to using it in areal world emergency. Reading these instructions does not

constitute proper training in this kit. These instructions are not

comprehensive nor a replacement or adequate training.

S.A.S.SURGICAL AIRWAY SETSTERILE - PRODUCT#: 40309 NSN#: 6515-CF-002-7744

TRAINING ONLY/NON-STERILE - PRODUCT#: 40305 NSN#: 6515-CF-002-7745

SUGGESTED INSTRUCTIONS FOR USE:

1. Identify the requirement for an emergency cricothyroidotomy asper your approved protocol.

2. Open the kit and utilize the wrapping paper as a clean eld.

3. Don gloves.

4. Empty contents o plastic bag onto wrapping paper and veriy

kit contents.

5. Clean the skin around and below the cricothyriod cartilage with the

chlorhexidine swab using aseptic technique.

6. Remove the saety tape rom the scalpel.

7. Stabilize the trachea with the thumb and middle nger o your

non-dominant hand.

8. Unguard the scalpel with the thumb o your dominant hand.

9. Identiy the notch between the cricoid and thyroid cartilage and make

a vertical (parallel with the axis o the body) incision with thescalpel, centered over the cricothyroid membrane, through the

sot tissue, down to the trachea, approximately 1.5 long.

DO NOT CUT CARTILAGE. See Figure: 1, 2, and 3.

1


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Figure: 1

Figure: 2 2


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10. Insert your index nger o your non-dominant hand into the incision

to conrm the location o the cricothyroid membrane. Place your

nger superior to the membrane, on the cartilage prominence.

See Figure: 4.

3

Figure: 3

Figure: 4


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Figure: 5

11. Using your nger as a guide to the landmark, insert the scalpel into

the incision in a horizontal orientation (perpendicular to the axis o

the body) and puncture the cricothyroid membrane large enough to

pass the tube. You should immediately hear air movement though the

puncture hole i the casualty is making respiratory eort.

DO NOT PUNCTURE THROUGH THE BACK OF THE TRACHEA.

See Figure: 5.

4

12. Lean the side o the scalpel blade against the cartilage prominence,

maintaining it in the punctured hole, and insert the small sharp hook

end o the Tracheal Hook into the hole, using the scalpel as a guide, all

the way to the back o the trachea. See Figure: 6.


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Figure: 6

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13. Rotate the hook 90 towards the eet.

14. Hook the trachea at the inerior aspect o the hole and provide

traction straight up. I done correctly, this should open the hole you

have created in the trachea enough to allow passage o the

Tracheal Tube.

15. Remove the scalpel rom the hole and slide the guard over the blade.See Figure: 7, and 8.

Figure: 7


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Figure: 8

Figure: 9 6

16. Maintaining traction on the trachea with the hook, insert the

Tracheal Tube directing it inerior, toward the lungs.

See Figure: 9, and 10.


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Figure: 10

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17. Lean the Tracheal Hook inerior and remove. See Figure: 11.

Figure: 11


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Figure: 12

18. Pull down the side wings o the Tracheal Tube and remove the stylette

rom the tube.See Figure: 12, 13, and 14.

Figure: 13


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Figure: 14

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19. Look, listen and eel or air passage through the tube. Conrm

tube placement.

20. I tube is in the correct location, infate the cu on the Tracheal Tube

using the syringe. Only infate with as much air as required to apply

gentle pressure.DO NOT OVER INFLATE. Remove the syringe rom

the Tracheal Tube. See Figure: 15.

Figure: 15


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10

21. Slide the Serpent Hook under the patients neck and secure to the

Tracheal Tube through the holes on the wings on both sides. Tighten

the Serpent Hook enough to prevent tube displacement but not so

tight as to restrict circulation.

22. Reassess tube placement and respirations.

23. Document all care provided.

TROUBLESHOOTING:

I the tube is not patent with respiration or ventilation, conduct the

ollowing troubleshooting steps. Consider that the tube may be in thecorrect place and the patient may be in respiratory arrest - attempt to

ventilate with BVM. I no air passage:

a. With your index nger, circumnavigate the tube at the point it

enters the cricothyroid membrane, eeling that the tube is inside

the trachea. You should not be able to eel the tube in the

pre-tracheal plane. I the tube is not in the trachea, remove it

and start the procedure again. I it is in the correct position;

b. Connect the syringe to the pilot bulb o the Trach Tube and defate

the bulb. There is a slight possibility the bulb may have been

overinfated causing it to deorm, obstructing the distal end o the

Trach Tube. I no air passage through the Trach Tube;

c. Remove the Trach Tube, reset equipment and start over.


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NOTES


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NOTES


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LEAVE NOTHING TO CHANCE.CONTROL THE CHAOS.

SM

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