Steps: (right handed)
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Left hand stabilizes thyroid cartilage (1)
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Left index rests over cricothyroid membrane (A)
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Right hand #10 scalpel makes vertical incision over entire cricothyroid area (3cm)
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Left index finger palpates for cricothyroid membrane
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Right hand #10 scalpel makes horizontal incision through crycothyroid membrane
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Left index finger goes in hole (insert bougie if using one)
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Place 6.0 endotracheal tube into hole (or slide over bougie)
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Secure tube
Anatomy:
(1)Thyroid cartilage
(2)Cricothyroid membrane
(3)Cricoid cartilage
(4)Trachea
(A) Cricothyrotomy site, through the median cricothyroid ligament
(B) Tracheostomy site
Excellent discussion and video demonstration here: Emergency Medicine Cases