Prior to percutaneous tracheostomy
- Helps identify relevant anatomy, such as the midline, tracheal rings (2-3rd) and depth of structures
- Identifies contraindications such as:
- Overlying blood vessels
- Overlying thyroid glands
Difficult airways
- In the latest DAS guidelines forms part of the strategies to help determine whether successful endotracheal intubation has occurred/to exclude oesophageal intubation
- Exclusion of the ‘double tract sign’ and visualisation of ‘lung sliding’ can exclude oesophageal intubation, but only if a trained operator is using it
- Can be used to identify the cricothyroid membrane, e.g. pre-induciton in patients in whom difficult intubation is anticipated
- Techniques include:
- Transverse; faster and better in short-necked individuals
- Longitudinal; identifies more structures (vasculature, cricotracheal membrane, tracheal interspaces)