Emergency Percutaneous Transtracheal Ventilation During Anesthesia Using Readily Available Equipment

Scuderi, Phillip E.; McLeskey, Charles H.; Comer, Paul B.

doi:10.1097/00132586-198306000-00029

Cited by 5 publications

(7 citation statements)

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“…An alternative would be to leave the barrel of the 3-ml syringe attached to the intravenous catheter, insert an 8-mm endotracheal tube adapter to the syringe barrel, and then attach to a ventilating system with a standard 22-mm adapter. Note that in the neonate or infant the cricothyroid membrane is quite small its identification may be difficult because the thryroid cartilage and the hyoid bone are difficult to differentiate necessitating puncture of the trachea below the level of the cricothyroid membrane to successfully enter the trachea pneumomediastinum) (41,42,(42)(43)(44)(45). A commercially available device designed for low pressure jet ventilation is available (Enk Oxygen Flow Modulation set; Cook Inc, Bloomington, IN, USA) but a 'poor man's' version can be constructed by cutting a side hole in the oxygen tubing which is then intermittently occluded to divert flow into the catheter (Figure 4).…”

Section: Cricothyrotomy By a Percutaneous Needle ⁄ Catheter ⁄ Trocharmentioning

confidence: 99%

Pediatric transtracheal and cricothyrotomy airway devices for emergency use: which are appropriate for infants and children?

Coté

Hartnick

2009

Pediatric Anesthesia

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SummaryCricothyrotomy or insertion of a transtracheal device is a life-saving maneuver that may be performed on an emergent or semi-elective basis as a means of bypassing an obstructed upper airway. A surgeon is trained to perform this life-saving procedure whereas most anesthesiologists are not facile with the scalpel. It is for this reason that many percutaneous devices have been developed for use by surgeons and nonsurgeons alike. Unfortunately, the majority of such devices are designed for use in adults and ⁄ or teenagers but are not appropriate for neonates and infants. The unique anatomy of the infant larynx, the small size of the cricothyroid membrane, and the technical difficulty of locating the correct anatomical structures make the use of most of these devices impractical if not outright dangerous in neonates and infants. This paper will review many (but not all) of the available devices, associated literature, pitfalls and dangers. It is emphasized that each clinician should become familiar with the advantages and disadvantages of these devices and obtain training with simulators or animal models. A strategy for management of the 'cannot ventilate, cannot oxygenate, cannot intubate' situation should be developed with age and size appropriate equipment.

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Section: Cricothyrotomy By a Percutaneous Needle ⁄ Catheter ⁄ Trocharmentioning

confidence: 99%

Pediatric transtracheal and cricothyrotomy airway devices for emergency use: which are appropriate for infants and children?

Coté

Hartnick

2009

Pediatric Anesthesia

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“…A previous study found that AMs without relief valves can be used for TTJV [ 8 , 9 ]. However, no acceptable tidal volume was obtained using a modern AM in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, several investigators have reported contradictory findings that the oxygen flush device of anesthesia machines (AMs) should or should not be used as a substitute for MJVs [ 6 – 9 ]. Since the MJV is a highly specialized and uncommon device, we also tried using the oxygen flush device attached to the AM for TTJV and compared this to the MJV in a lung model with variable UAR.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Transtracheal Jet Ventilation with Various Upper Airway Obstruction

Doi

Miyashita

Furuya

et al. 2015

BioMed Research International

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A “cannot-ventilate, cannot-intubate” situation is critical. In difficult airway management, transtracheal jet ventilation (TTJV) has been recommended as an invasive procedure, but specialized equipment is required. However, the influence of upper airway resistance (UAR) during TTJV has not been clarified. The aim of this study was to compare TTJV using a manual jet ventilator (MJV) and the oxygen flush device of the anesthetic machine (AM). We made a model lung offering variable UAR by adjustment of tracheal tube size that can ventilate through a 14-G cannula. We measured side flow due to the Venturi effect during TTJV, inspired tidal volume (TVi), and expiratory time under various inspiratory times. No Venturi effect was detected during TTJV with either device. With the MJV, TVi tended to increase in proportion to UAR. With AM, significant variations in TVi was not detected with changes in any UAR. In conclusion, UAR influenced forward flow of TTJV in the model lung. The influence of choked flow from the Venturi effect was minimal under all UAR settings with the MJV, but the AM could not deliver sufficient flow.

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“…Zum Notfalleinsatz dieser Technik kursieren zahlreiche Reporte, in denen über die Kombination verschiedenster primär nicht zur Atemwegssicherung gedachter Gegenstände (Venenverweilkanülen, Dreiwegehähne etc. ; [3,5,14,15,17,18]) zur Durchführung der Beatmung berichtet wird.…”

Section: Hintergrund Und Fragestellungunclassified

Präklinische transtracheale Notfallventilation

et al. 2007

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Emergency Percutaneous Transtracheal Ventilation During Anesthesia Using Readily Available Equipment

Cited by 5 publications

References 0 publications

Pediatric transtracheal and cricothyrotomy airway devices for emergency use: which are appropriate for infants and children?

Pediatric transtracheal and cricothyrotomy airway devices for emergency use: which are appropriate for infants and children?

Percutaneous Transtracheal Jet Ventilation with Various Upper Airway Obstruction

Präklinische transtracheale Notfallventilation

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