Failed emergency transtracheal ventilation through a 14-gauge intravenous catheter.
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.
Metz
S
S
Department of Anesthesiology, School of Medicine, Medical College of Pennsylvania, Philadelphia 19129, USA.
Parmet
J L
JL
Levitt
J D
JD
D000368:Aged; D000776:Anesthesiology / Q000379:methods*; D001026:Coronary Artery Bypass; D004630:Emergencies; D005336:Fiber Optic Technology; D006801:Humans; D001239:Inhalation; D007431:Intraoperative Complications / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D012121:Respiration, Artificial; D014132:Trachea / Q000601:surgery*