Summary
In a patient whose airway is in jeopardy after unsuccessful attempts at conservative measures to clear it and after failed attempts at intubation, the intravenous tubing connector spike may be considered as an emergency percutaneous tracheostomy device. It is readily available wherever physicians have intravenous solutions at hand. It is inserted through the cricothyroid space with the help of a scalpel blade or other sharp instrument such as a pair of scissors. A severed spike can be as easily carried in a pocket, purse or medical bag as can an intravenous cannula. A number 11 scalpel blade fits neatly between two credit cards. The shape of the spike makes it fortuitously adaptable to intermittent positive pressure ventilation by mouth or standard resuscitation equipment. If the patient is otherwise well enough, it is of sufficient bore to allow spontaneous respiration. I have been fortunate not to have had the opportunity to use this device in an emergency situation as of the time of the submission of this paper.
Résumé
Lorsque dans ľobstruction des voies aériennes supérieures les mesures usuelles de déblocage et les tentatives ďintubation s’avèrent infructueuses, ľembout perforant ďune tubulure ďadministration de solutions intraveineuses peut être utilisé comme canule de trachéostomie ďurgence. Cet embout disponible partout où on administre des solutés est inséré à travers la membrane cricothyrodienne après incision avec une lame de bistouri ou tout instrument tranchant comme une paire de ciseaux par exemple. Ľembout, une fois séparé de la tubulure se transporte facilement dans les poches, la bourse ou la trousse médicale. Une lame de bistouri No. 11 se glisse bien entre deux cartes de crédit. La forme de ľembout est compatible avec la ventilation positive intermittente soit par la bouche soit par un appareil standard et si ľétat du patient le permet, il est de calibre suffisant pour permettre ta respiration spontanée.
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Presented at the Annual Meeting, Canadian Anaesthetists’ Society, May 23,1978.
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Fisher, J.A. A “last ditch” airway. Canad. Anaesth. Soc. J. 26, 225–230 (1979). https://doi.org/10.1007/BF03006988
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DOI: https://doi.org/10.1007/BF03006988