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Mon Apr 28 18:54:18 BST 2008

----- Forwarded Message ----
From: "Spiro,Jeffrey" <Spiro at NSO.UCHC.EDU>
To: Ivan Hronek ivanhronek at yahoo.com
Jeff's paper on jet ventilation: 
http://archotol.ama-assn.org/cgi/content/full/131/10/886

Ivan,
I checked the discussion sting per the link you supplied and would offer the following:
Our report in Archives of Otolaryngology dealt exclusively with trans-tracheal jet ventilation in the setting of elective surgery. We feel it is a very useful adjunct in a patient with a stable airway pre-op who you believe may be difficult (if not impossible) to intubate. I have very little experience using this technique in an emergency setting, and would not advocate it as a matter of routine. First, you need to have all the appropriate equipment on hand which can be an issue. More importantly, in a hypoxic patient who is thrashing around it can be very difficult to place the catherter and to keep it there. Furthermore, you don’t really know what the outflow situation might be which increases the potential for complications. It is certainly possible that it could work in the right emergency setting, but I would advocate caution in this application.
Hope this helps,
Jeff Spiro
spiro at nso.uchc.edu

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