title: Needle cricothyroidotomy revisited.
abstract: Needle cricothyroidotomy may provide a life-saving airway when tracheal intubation is not possible. Indications for needle cricothyroidotomy are discussed. Methods of needle/angiocatheter insertion and proposed means to connect to an oxygen source for intermittent insufflation are reviewed. A new technique for administering effective oxygenation and ventilation through a trans-tracheal catheter using materials commonly available in an emergency department is presented. Potential complications are discussed. Complete upper airway obstruction is a contraindication to needle cricothyroidotomy because of the risks of barotrauma. In a crisis situation, the emergency practitioner needs a simple, reliable, effective, and preplanned technique to deal with the "nightmare airway."
authors.affiliation: Department of Emergency Medicine, Boston Medical Center, Massachusetts 02118, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Peak
authors.forename: S
authors.initials: S
authors.lastname: Roy
mesh_terms: D000402:Airway Obstruction / Q000601:surgery*; D002648:Child; D000075202:Contraindications; D004638:Emergency Treatment / Q000379:methods*; D006801:Humans; D007327:Insufflation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D008566:Membranes / Q000601:surgery; D009339:Needles; D011677:Punctures / Q000009:adverse effects / Q000379:methods; D012121:Respiration, Artificial / Q000379:methods*; D013957:Thyroid Cartilage / Q000601:surgery*