Post Cricothyrotomy/Endotracheal Intubation Checklist

  •  Double check placement with waveform capnography or capnometry, placed directly on ET tube adapter.
  •  Check proper tube depth (not main stem) by auscultating bilateral lung sounds
  •  Check that tube is secured (suture to skin + tie with girth hitch around neck, should be able to fit 2 fingers under the tube tie)
  •  Bag‐valve‐mask (BVM) with positive end‐expiratory pressure (PEEP) valve @ 5 of PEEP at proper volume (one hand moderate squeeze) and proper rate (one squeeze every 5-6 seconds)
  •  Provide adequate analgesia and sedation (follow analgesia and sedation CPG)
  •  Calculate remaining medication and establish analgesia and sedation plan. A patient with a cricothyroidotomy may not require heavy continuous sedation.
  •  Raise the head and torso to 30 - 45°
  •  Filter and humidify the air with a heat moisture exchanger. Place HME in-line distal to EtCO2
  •  As needed, place in-line suction for the tube, and suction the mouth for any excess secretions
  •  Check cuff pressure (palpate bulb – should be moderately firm but still compressible)
  •  Place orogastric tube, if available.
  •  Put a BVM +PEEP valve at the bedside if using a mechanical ventilator.
  •  Decontaminate the mouth with chlorhexidine swab or toothbrush without paste as per the nursing care plan.