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Tue Apr 29 01:56:15 BST 2008

A cric is NOT faster and the needle catheter does NOT get in the way.  Although is it the lowest level of research, my N for crics is much larger than 3     :>)

Norman

Norman McSwain Jr, MD FACS
Trauma Director Charity Hospital
Professor of Surgery
Tulane University School of Medicine
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Ivan Hronek
Sent: Sunday, April 27, 2008 6:59 PM
To: trauma-list at trauma.org
Subject: Fw: [ccm-l] PRO & CON: jet ventilation/needle cric.

----- Forwarded Message ----
From: Bergmann Terence <bergmann at cc.umanitoba.ca>
To: Ivan Hronek <ivanhronek at yahoo.com>
Cc: CCM-L critical <ccm-l at ccm-l.org>
Sent: Sunday, April 27, 2008 3:55:03 PM
Subject: Re: [ccm-l] PRO & CON: jet ventilation/needle cric.

I lean towards not necessary, unless the operator is unwilling to cut the neck open.  If you are comfortable in being ready to do a cric it is probably faster to just slice and insert the tube (I have an N=3 after 17 years of full time ER).  Every department I have worked in either has the expensive contraption, or the parts in a bag to make the homemade job, taped to the wall in Resus, but I have never known anyone who has used them.

The problem with needle jet ventilation is that you will not ventilate (only oxygenate) the patient on this and will have to open the neck anyway, and now your angiocath is in the way.

I am not opposed to someone having it or using it, but it depends on having a rescuer available soon to make a more definitive airway.

Terence Bergmann

On 27-Apr-08, at 12:27 PM, Ivan Hronek wrote:

Question to all: in the trauma bay for patients who are not intubatable for any reason
the setup for jet ventilation to be able to utilize needle cricothyrotomy:

PRO

IS necessary, because any additional method to ventilate is worth the expense...
 CON

is NOT necessary, as surgical airway such as cricothyrotomy
is more definitive and should be doable just as well...
I wish jet ventilation was available in my institution also because ....

Thanks for the answers !

Ivan Hronek MD
SFMC, Los Angeles
cell: 310 487-3288
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[ccm-l] PRO & CON: jet ventilation/needle cric.