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.