when pt hears that they have cancer
1. they stop listening for a while
2. they jump to the conclusion that its a terrible death sentence (not all cancers are bad/incurable). not all cancers are terminal. 5 year survival is better than its ever been. there are others diseases that are just as bad.

cancer drugs are improving quickly.

a chapter about how parents can tell children. gathering resources because treatment is toxic and fatiguing.

making decisions about treatment, alternative treatments – practical factual advice, pt has to make decision. dr gives pt facts e.g. to help them decide about internet scams etc.


– disinfect skin
– locate cricothyroid membrane inferior to thyroid cartilage
– vertical incision (so it can be lengthened
– feel for membrane – keep finger on membrane
– horizontal incision – keep finger in incision
– thread in tubing
– bag ventilation


avoiding recurrent laryngeal nerves

avoiding major vessels in neck (common carotid and IJV)