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Percutaneous transtracheal ventilation: experimental and practical aspects.

C C Neff, R C Pfister, E Van Sonnenberg

    The Journal of Trauma
    |February 1, 1983
    PubMed
    Summary
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    Percutaneous transtracheal ventilation using a 15-gauge needle and oxygen can be a lifesaving emergency airway when endotracheal intubation fails. A 3.0-mm cannula provided an adequate airway in all tested scenarios.

    Area of Science:

    • Emergency Medicine
    • Anesthesiology
    • Critical Care

    Background:

    • Endotracheal intubation is the standard for airway management.
    • Percutaneous transtracheal ventilation (PTV) is a critical alternative when intubation is impossible.
    • Understanding PTV techniques and equipment is vital for emergency airway management.

    Purpose of the Study:

    • To define the conditions for emergency PTV using a 15-gauge needle and oxygen.
    • To evaluate the adequacy of a 3.0-mm internal diameter (I.D.) cannula for PTV.
    • To assess alternative equipment for PTV.

    Main Methods:

    • The study was conducted on adult sheep.
    • A 15-gauge needle connected to oxygen at 50 pounds per square inch (psi) was used for PTV.

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  • Cannula sizes, including 3.0-mm I.D., were evaluated.

    • Main Results:

    • A 15-gauge needle with oxygen at 50 psi can provide an emergency transtracheal airway under specific circumstances.
    • PTV is contraindicated in cases of complete airway obstruction.
    • A 3.0-mm I.D. cannula proved adequate for transtracheal airway in all examined conditions.

    Conclusions:

    • PTV is a viable emergency airway technique when endotracheal intubation is not feasible.
    • Familiarity with PTV, including the use of a 3.0-mm cannula, is essential for physicians managing airway emergencies.
    • Simpler equipment, like self-inflating resuscitation bags, can also be used for PTV.