A guy recently asked if he should buy or make his own trach kit. I answered him:
Make your own kit. You probably have access to 5.5 ET tubes? Get a 5.0 or 5.5 (smallest cuffed tubes). Cut down to just above where the fill tube for the balloon/cuff (do not cut the little tube that fills the distal cuff/balloon) comes out the side of the ET tube shortening the tube, as you know you do not need the length for the oropharynx with a trach.
ET Tube
Re-attach the adapter that receives the BVM or vent tube into the new shorter ET tube. Keep the tube with a surgical scalpal, some 2x2 and or 4x4 gauze, 18 ga needle, 10cc syringe and a trach hook in an appropriate sterile container or baggy. Perform procedure as you are trained and within your scope and protocols of course. Needle serves as a nice guide after marking the cricothyroid membrane and inserting into the space, scalpal used for vertical incision, using gauze to stabilize trachea midline and absorb blood. Having another set of hands is great.
After incision, retain visual and control of the trachea with trach hook. Introduce the tube into the trachea until cuff is below insertion point and above carina. Inflate cuff as you would, confirm placement with auscultation of breath sounds, chest rise, ETCO2, bulb syringe etc. Secure in place as an impaled device with tape and or an ET tube holder if one fits the neck.
- this is for research and educational purposes only. DO NOT ATTEMPT THIS OUTSIDE YOUR SCOPE OR AN APPROPRIATE FACILITY.