- This is a technique that uses a combination needle cric, with a Seldinger-over-the-wire method to place the ET tube blindly. To perform, you need a syringe and needle, a long guide wire thin enough to pass through your needle, 2 clamps and the ET tube.
- First, puncture the cricothyroid membrane with your needle while aspirating with the syringe. You know that you are in the trachea when air freely withdraws. Remove the syringe and pass the guidewire through the needle aiming towards the head. Simultaneously look into the oropharynx and grab the wire with the clamp. Clamp off the tracheal end at the level of the skin and pull taut. Load the ETT over the wire through the Murphy"s eye. Advance the tube over the wire into the cricoid area, then relax the cricothyroid end of the wire and advance the tube into the trachea. It may be difficult to pass the tube through the cords. If so, reposition and try again. When the ETT is in place, release the wire and withdraw.
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