Comparison of blind and electrically guided tracheal needle insertion in human cadavers

The purpose of this study was to investigate whether an electrically guided needle insertion technique would enable greater success at intratracheal needle tip insertion than the traditional, aspiration-of-air technique. Twenty-seven anaesthesiology residents were assessed in their ability to place a needle tip in the trachea of cadavers using the two methods. Success of needle placement, time to placement and confidence in placement were recorded. Correct intratracheal needle placement was achieved by 22% of residents (6/27) using the aspiration-of-air method vs 82% (22/27) using the electrically guided method (p<0.001). For the instances of success, there was no significant difference between the two methods in the median (IQR [range]) time taken (28 (24-49 [18-63]) s aspiration vs 32 (19-49 [15-84]) s electrical; p=0.93). The electrically guided method provides an acceptably quick and accurate way of placing a needle tip into the tracheal lumen and can be learnt easily by anaesthesiology residents.