Palm Beach County Fire Rescue
Paramedic Graduate School
Skills Assessment Evaluation
Name: _________________________________ Skill: Cricothyrotomy
Date: ________________ Total Points Page 1: ______
Performance Objective:
Given all the necessary equipment, the paramedic will recognize the need for and be able to
properly perform a cricothyrotomy.
Reference:
1998 D.O.T. Paramedic Curriculum
Florida Regional Common EMS Protocols 2004
Therapeutic Effects: V P P
Establish and maintain an open airway 1
Indications:
Relief of life-threatening upper airway obstruction in which 1
manual maneuvers to establish an airway, endotracheal intubation,
is not possible and attempts at ventilation have failed.
Severe laryngeal edema or facial and upper laryngeal trauma that 1
prevent successful intubation by direct visualization.
Contraindications:
Needle cricothyrotomy is recommended when unable to 1
oxygenate/ventilate children less than 12 years of age.
Side Effects:
Hemorrhage 1
False Passage 1
Subcutaneous or mediastinal emphysema 1
Damage to Thyroid or Parathyroid glands 1
Revised 08/05 1
Palm Beach County Fire Rescue
Paramedic Graduate School
Skills Assessment Evaluation
Name: _________________________________ Skill: Cricothyrotomy
Date: ________________ Total Points Page 2: ______
Demonstration of the Procedure V P P
Takes or verbalizes appropriate Body Substance Isolation (BSI) 2
precautions
Hyperextends the neck unless contraindicated 2
Identifies the Cricothyroid Membrane 2
Retracts the skin and preps with Betadine solution 2
Using a scalpel, makes a vertical incision through the skin and a 2
horizontal incision just large enough to accommodate a 6.0 ETT
through the cricothyroid membrane
Once the scalpel blade has passed through the membrane, inserts 2
hemostats into the incision to maintain the opening
Removes the scalpel blade and inserts the 6.0 ETT caudally 2
through the incision
Ventilates patient with 100% oxygen at the appropriate rate and 2
depth
Verifies proper ETT placement via bilateral breath sounds, 2
absent epigastric sounds, ETCO2 detector, equal chest rise,
direct visualization, ETT fogging, pulse oximetry, etc.
Inflates the cuff with 10cc’s of air and secures the tube in place 2
Properly disposes of the scalpel in an approved container 2
Bolded are mandatory placement verification methods.
Page 1 Possible Points: 8
Page 2 Possible Points: 22
Total Possible Points: 30
Successful completion minimum (80%) 24
Total points received: ________________
Revised 08/05 2
Palm Beach County Fire Rescue
Paramedic Graduate School
Skills Assessment Evaluation
Name: _________________________________ Skill: Cricothyrotomy
Date: ________________
Critical Criteria:
_____Did not take or verbalize BSI precautions.
_____Failure to exercise aseptic technique.
_____Incorrectly identifies membrane.
_____Failure to properly complete the procedure.
_____Failure to properly dispose of the scalpel.
Evaluator Signature: _____________________________ Date: ____________________
Evaluator Print: _______________________________
Evaluator Signature: _____________________________ Date: ____________________
Evaluator Print: _______________________________
Revised 08/05 3