SAK tracheotomy

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Sep 19, 2001
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I apologize if this has been mentioned before (ran a search and didn't find anything specific) but I've had the SciFi channel on this afternoon and there was a movie on earlier (called Inferno) that started with a kid being stung by a jellyfish. He couldn't breathe and out of the crowd that gathered around him appeared a guy who identified himself as a doctor and proceeded to do an emergency tracheotomy with his SAK. It just gave me a bit of a giggle to see that. :D

BTW, I *know* it was pure scifi 'cause nobody freaked out and asked him why he was carrying such a dangerous weapon on the beach.
 
Supposedly, a real trach was done with an SAK on a jetliner. Once in a while you see it mentioned and occasionally in the SAK priint ads.
 
Of course that could not happen now. Person would have to die, or the air marshal would have to shoot the SAK weilder before he could use the saw to shear off a wing and send the plane plummeting into a large city to hit a school full of children being attended to by nuns and senior citizens.
 
The world becomes scarier everyday and knee-jerk politics onlt fuels the fire.

Paul
 
Back in 1992 I helped perform an emergency tracheotomy. I was bartending a wedding catered by a friend I occasionally helped out for extra cash. The location was a rather secluded and remote estate owned by the groom's family in Sonoma. The bride's father whom I had been chatting with a half hour earlier collapsed (I later found out it was an allergic reaction to an insect bite) and was unconscious. I was first aid certified and rushed over to offer assistance to a guest who just so happened to be a paramedic on medical leave because of a broken arm.

We started two man CPR, I did compressions and he did breaths, but swelling restricted the man's windpipe. 911 was called but it would be at least 10-15 minutes before help would arrive due to the location. The paramedic felt an emergency tracheotomy was necessary but couldn't do it with his arm casted. He asked if I would do it if he talked me through. I agreed. The incision was done with a Spyderco Worker I carried. The tube was a section of hose I cut from a jockey box used to dispense keg beer, well soaked with Bacardi 151 to sterilize. Emergency services arrived 10 minutes after breathing was re-established, well after the man would have expired if nothing was done.

My friend contacted me two weeks later to tell me that the bride had given her an envelope addressed to me. Enclosed was a card signed by every guest that had attended, notes from the bride and groom, the paramedic, the bride's father, and 50 crisp $100 bills. That was the biggest tip I ever got bartending.

Dayuhan
 
How to Perform an Emergency Tracheotomy

This procedure, technically called a cricothyroidotomy, should be undertaken only when a person with a throat obstruction is not able to breathe at all-no gasping sounds, no coughing-and only after you have attempted to perform the Heimlich maneuver three times without dislodging the obstruction. If possible, someone should call for paramedics while you proceed.

What you will need
  • A first aid kit, if available
  • A razor blade or very sharp knife
  • A straw (two would be better) or a ballpoint pen with the inside (ink-filled tube) removed. If neither a straw nor a pen is available, use stiff paper or cardboard rolled into a tube. Good first aid kits may contain "trache" tubes.

There will not be time for sterilization of your tools, so do not bother; infection is the least of your worries at this point.

emergency1.gif

Find the indentation between the Adam's apple and the Cricoid cartilage.

emergency2.gif

Make a half-inch horizontal incision about one half inch deep.

emergency3.gif

Pinch the incision or insert your finger inside the slit to open it.

emergency4.gif

Insert your tube into the incision, roughly one-half to one inch deep.

Step by Step
  1. Find the person's Adam's apple (thyroid cartilage).
  2. Move your finger about one inch down the neck until you feel another bulge. This is the cricoid cartilage. The indentation between the two is the cricothyroid membrane, where the incision will be made.
  3. Take the razor blade or knife and make a half-inch horizontal incision. The cut should be about half an inch deep. There should not be too much blood.
  4. Pinch the incision open or place your finger inside the slit to open it.
  5. Insert your tube in the incision, roughly one-half to one inch deep.
  6. Breathe into the tube with two quick breaths. Pause five seconds, then give one breath every five seconds.
  7. You will see the chest rise and the person should regain consciousness if you have performed the procedure correctly. The person should be able to breathe on their own, albeit with some difficulty, until help arrives.
    [/list=1]

    Source: The Worst-Case Scenario Survival Handbook by Joshua Piven and David Borgenicht
 
Release Date: February, 1998
Physician saves a life with his trusty knife
by Denny Angelle

Dr. Keith Reeves doesn't mind admitting he's still a bit of a Boy Scout, particularly when it comes to that motto 'Be Prepared.'

Although it's been a long time since Reeves was an Eagle Scout, he still keeps his pocket knife razor sharp. Just in case.

Reeves, an obstetrician/gynecologist at The Methodist Hospital and Baylor College of Medicine, encountered that 'just in case' scenario on Dec. 17. He was attending a luncheon meeting of the University of Texas Friars' Society, an honorary group that is the oldest organization on the UT campus, at the River Oaks Country Club.

As the main speaker began his talk, Reeves noticed a man seated at another table had started to choke. "They served filet mignon, and I assumed the gentleman was having trouble with a piece of meat," Reeves said.

Reeves, along with Dr. William Francis, a Methodist/Baylor orthopedic surgeon, and a female neurologist from Baytown (whose name Reeves never caught), immediately applied the Heimlich maneuver to the man. "He obviously wasn't moving any air at all before the Heimlich," said Reeves, "and he wasn't breathing afterwards."

As the man began to turn ashen gray and then blue from lack of air, country club personnel produced an oxygen tank and mask. After that was tried to no avail, Reeves and Francis noted that nearly three minutes had elapsed since the man stopped breathing.

With the patient's life literally in his hands, Reeves whipped out his razor-sharp Swiss Army Knife and decided to perform an emergency tracheotomy. With Francis stabilizing the patient, Reeves cut into the man's trachea and opened a small airway.

"Somebody produced a piece of plastic, a tube of some sort (one unverified report said it was a plastic spout from a wine bottle) that we used to keep the airway open until paramedics arrived," Reeves said.

When they did arrive, the emergency medics used forceps to remove a large chunk of meat from the man's throat. The man, retired attorney Frank J. Knapp, was taken to The Methodist Hospital, where he spent a few days in intensive care before he was moved to a private room in Main building last week to continue his recovery.

"We believe that certain things happen for a particular reason, and Frank says this happened because he still has a mission, he has some things still to accomplish," said Inez Knapp, who has stayed with her husband around the clock since he came to the hospital.

When the choking incident happened, Mr. Knapp was recovering from the effects of a stroke. His wife said that over the past two weeks his condition has steadily improved.

"I would just like to thank Dr. Reeves and all those who were involved in saving my husband's life," added Mrs. Knapp. "I cannot begin to express how deeply we appreciate your efforts."

Reeves accepts the attention modestly and chalks up his quick thinking to that old Eagle Scout training and something else: "I'm a graduate of Baylor College of Medicine. You don't come through this program without learning a little bit of everything."
 
Person would have to die, or the air marshal would have to shoot the SAK weilder before he could use the saw to shear off a wing and send the plane plummeting

You could always perform the tracheotomy with the marshal's gun. It might be a bit less controlled, maybe a bit messier, but at least we'll all feel safer... except for the poor choking victim.
:D
 
Some of the smaller Victorinox models have an emergency tracheotomy blade, the one that is vaguely Wharnecliffe like. They just call it an "emergency" blade or something similar for the US brochures.

dayuhan13,
That was a great story.

Paul
 
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