Emergency Medicine at HCMC
Procedure Lab > PTTNV

PERCUTANEOUS TRANSTRACHEAL NEEDLE VENTILATION

INDICATIONS

a)	Severe neck and facial trauma
b)	Intraoral trauma
c)	Subglottic stenosis
d)	Laryngeal fracture
e)	Facial/oral anatomical abnormalities
f)	Failed endotracheal intubation

TECHNIQUE

a)	Intermittent jets of oxygen under high pressure (50 psi)
b)	14-16 gauge cannula will flow 400-500 cc/second
c)	Locate cricothyroid membrane
d)	Insert 14 gauge 8.5 cm long catheter at a 45 degree caudad into trachea and withdraw on syringe. Check placement by aspirating air into the syringe.
e)	Ventilate at a rate of 12/minute with an inspiration phase of 1 to 1.5 seconds

Figure 1-13. Translaryngeal catheter ventilation. (From Clinton.)

COMPLICATIONS

a)	Hemorrhage
b)	Esophageal perforation
c)	Subcutaneous and mediastinal emphysema
d)	Introduction of foreign matter into respiratory tree

For more information contact Richard O. Gray MD.

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Manual last modified: Wednesday May 07, 2003.