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Updated: Aug 16, 2026

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Failed emergency transtracheal ventilation through a 14-gauge intravenous catheter
S Metz1, J L Parmet, J D Levitt
1Department of Anesthesiology, School of Medicine, Medical College of Pennsylvania, Philadelphia 19129, USA.
Abstract:
We encountered two patients who could be neither ventilated nor intubated after induction of anesthesia. In both cases, transtracheal ventilation failed after emergent cricothyroid membrane puncture with a 14-gauge intravenous (i.v.) catheter. In the first case, two catheters placed in rapid succession kinked, preventing gas exchange. In the second case, absence of a plunger on the needle-over-catheter assembly prevented confirmation of intratracheal placement. Both patients required emergent tracheal access by the surgeon. We suggest that transtracheal ventilation via standard i.v. catheters as a primary emergent rescue technique be reassessed.
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