Abstract

CRICOTHYROTOMY via a large bore needle is an acceptable method of providing temporary oxygenation in emergency situations when intubation (oral or nasal) cannot be accomplished. Various devices have been constructed in recent years to facilitate puncture of the cricothyroid membrane. The use of many of these devices, however, necessitates surgical incision through the skin to facilitate puncture. This additional step in itself can be a crucial time factor in an emergency.Our device not only provides rapid airway access, but also features a pediatric endotracheal tube connected to a 12 gauge catheter (Figure). A 5.5 mm pediatric endotracheal tube (Sheridan) is cut to a desired length and inserted approximately 1.5 to 2.0 cm into the syringe of a 12 gauge Angiocath (Deseret Medical, Inc.). The 15 mm endotracheal tube connector can also be fitted onto the distal end of the endotracheal tube to cover one half of the Murphy eye, providing a side port for exhalation. The endotracheal tube extension adds flexibility to ventilatory circuit hook-ups, Ambu bags, demand valves, or jet ventilators. Unlike traditional devices, it also provides greater surgical access during the conversion of this temporary airway to a more definitive one.Although sterility in an emergency situation is not often the primary concern, these devices are easily preassembled, sterilized with gas, and packaged. We recommend that these devices be available in every anesthetic machine drawer because of their small size, low cost, simplicity of construction, and potential life-saving capability.