title: Bystander cricothyroidotomy performed with an improvised airway.
abstract: OBJECTIVE
  We report a roadside cricothyroidotomy successfully performed with only a pocketknife and the drinking straw from a sports bottle. Our study compared the adequacy of standard medical airway devices with some readily available nonmedical items that might be used as temporary tracheostomy tubes (TT).
  
  
  METHODS
  We compared the airway resistances (Raw) of two standard cricothyroidotomy airway devices against the barrel from a ballpoint pen and two sports bottle straws.
  
  
  RESULTS
  There was no statistically significant difference in Raw between the straws and standard airway devices. However, the pen barrel had much higher Raw.
  
  
  CONCLUSIONS
  This is the first study to compare available nonmedical items that might be used as temporary TTs for bystander cricothyroidotomy. Two types of straws found on sports bottles had relatively low Raw compared with standard TTs. However, the barrel from a ballpoint pen had a much higher Raw and is an unacceptable choice.
authors.affiliation: Dwight David Eisenhower Army Medical Center, Fort Gordon, GA, USA.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Adams
authors.forename: Warren L
authors.initials: WL
authors.lastname: Whitlock
mesh_terms: D000704:Analysis of Variance; D003413:Cricoid Cartilage / Q000601:surgery*; D004630:Emergencies; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D010865:Pilot Projects; D013957:Thyroid Cartilage / Q000601:surgery*; D014139:Tracheostomy / Q000295:instrumentation*