Bystander cricothyroidotomy performed with an improvised airway

We report a roadside cricothyroidotomy successfully performed with only a pocketknife and the drinking straw from a sports bottle. Our study compared the adequacy of standard medical airway devices with some readily available nonmedical items that might be used as temporary tracheostomy tubes (TT).

We compared the airway resistances (Raw) of two standard cricothyroidotomy airway devices against the barrel from a ballpoint pen and two sports bottle straws.

There was no statistically significant difference in Raw between the straws and standard airway devices. However, the pen barrel had much higher Raw.

This is the first study to compare available nonmedical items that might be used as temporary TTs for bystander cricothyroidotomy. Two types of straws found on sports bottles had relatively low Raw compared with standard TTs. However, the barrel from a ballpoint pen had a much higher Raw and is an unacceptable choice.