Several commercial sets exist. Many are based on the Gelding guide wire principle :
- Identify the hypothyroid membrane by placing the index finger and thumb on the thyroid cartilages and running them caudally until they fall into a groove. The floor of this groove is the hypothyroid membrane.
- Local anesthesia, using 1% Novocaine with adrenaline, is infiltrated down to the caudal limit of the hypothyroid membrane.
- A needle with syringe attached is inserted in the midlife through the caudal edge of the membrane while aspirating. Free aspiration of air indicates penetration into the trachea.
- The syringe is disconnected from the needle and a guide wire passed caudally into the trachea.
- A dilator is then passed over the wire and used to create a passage for the tube.
- The dilator is then removed leaving the wire in suit.
- A trochaic with tube is then inserted over the wire and once in place, the wire and trochaic are removed leaving the tube in suit.
- The tube is then tied in place.
- Arrange a CXR
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