A-
Inject 1% novocain and adrinaline along anterior border of both
sternomastoid muscles and along the upper border of thyroid cartilage.
B- No need for anesthesia in urgent cases.
C- The patient should be supine with extended neck.
D-
Midline longitudinal incision from upper border of cricoid cartilage to
suprasternal notch including “skin – subcutaneous tissue – platysma and
fascia”.
E- Separate between sternohyoid and sternothyroid in the midline.
F- Retract thyroid isthmus upward.
G- Dissect pretracheal fascia from anterior tracheal wall.
H- Open trachea and avoid blood aspiration or cough reflex.
I Remove circular portion of 3, 4 tracheal rings.
J- Insert tube to be of same diameter of the opening.
K Close the wound.
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