Puncture cricothyroid membrane (CTM) with a needle attached to a 5 mL syringe.
Confirm tracheal entry by aspirating air into the syringe.
A. The cricothyroid membrane is identified by palpation and is located between the thyroid cartilage and cricoid cartilage. B. Insert the aspiration needle through the cartilage and direct 45 degrees caudad while aspirating the saline-filled syringe for the presence of air bubbles. Stop advancing the needle when air is aspirated in the syringe. The needle is now in the trachea.
Insert wire through the needle and remove the needle.
Make a stab incision caudally with a scalpel.
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