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Airway Surgery
Published in T.M. Craft, P.M. Upton, Key Topics In Anaesthesia, 2021
Intermittent jet ventilation using a hand-held injector will entrain room air via the Venturi principle and can be used with either a catheter through the cords or attached to the side of a ventilating rigid bronchoscope. Transtracheal jet ventilation, either with a hand held injector or a high frequency jet ventilator, may be used via a cricothyroid cannula to maintain oxygenation where the anatomy of the larynx is severely abnormal. With jet ventilation a clear expiratory pathway must be present to avoid barotrauma. Apnoeic oxygenation and methods of jet ventilation require incremental doses or infusions of intravenous anaesthetic agents to prevent awareness.
Anaesthesia and resuscitation
Published in Jan de Boer, Marcel Dubouloz, Handbook of Disaster Medicine, 2020
Joost J. L. M. Bierens, Francois P. Gijsenbergh, Marc Sabbe
Techniques such as laryngeal mask, trachlight or transtracheal jet ventilation can be used. These devices are used and accepted for pre-hospital care. However, the selection of airway equipment in disaster situations should not be motivated by a limited need of competence, experience or training. All airway management techniques have to be learned through a specific training programme.
Adult Anaesthesia
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Daphne A. Varveris, Neil G. Smart
In comparison, the subglottic approach requires a narrow catheter or tube such as a Hunsaker and this may limit surgical access posteriorly. However, vocal cord movement is minimal. Furthermore, ETCO2 can be monitored and with minimal entrainment of air, inspired oxygen delivery is more consistent (Figure 32.8).7 Transtracheal jet ventilation can be used as a rescue technique.
Prehospital Surgical Airway Management: An NAEMSP Position Statement and Resource Document
Published in Prehospital Emergency Care, 2022
Robert F. Reardon, Aaron E. Robinson, Rebecca Kornas, Jeffrey D. Ho, Brendan Anzalone, Jestin Carlson, Michael Levy, Brian Driver
When performing surgical airways, EMS clinicians experience higher success with the use of open scalpel techniques (11). Also, most emergency physicians prefer an open scalpel technique when performing an emergency surgical airway. A systematic review of transtracheal jet ventilation concluded that it was associated with a high risk of device failure and barotrauma and recommended against using it in the emergency setting (49). In addition, there has been debate in the anesthesiology literature about the relative merits of needle cannula (Seldinger: needle-guidewire-cannula) techniques (50). However, the 4th National Audit Project of major airway complications in the United Kingdom evaluated 79 failed airways in the hospital setting that required a surgical airway. They found a 2% failure rate for open surgical airway techniques compared with a 65% failure rate for needle cannula techniques (51). These findings led to the Difficult Airway Society’s strong recommendation for the use of scalpel cricothyrotomy techniques (46). In addition, data from the National Emergency Airway Registry shows that in U.S. emergency departments open scalpel techniques have now completely supplanted needle cannula techniques (52).