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Emergency transtracheal ventilation: assessment of breathing systems chosen by anaesthetists
Author(s) -
RYDER I. G.,
PAOLONI C. C. E.,
HARLE C. C.
Publication year - 1996
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1996.tb07892.x
Subject(s) - jet ventilation , medicine , ventilation (architecture) , anesthesia , oxygenation , cannula , interquartile range , surgery , mechanical engineering , airway , engineering
Summary The choice of equipment for emergency transtracheal ventilation and the time taken to assemble it were surveyed in 39 anaesthetists. Thirty seven (95%) assembled a system in a median time of 104s (interquartile range 54s to 120s). Systems specially constructed from oxygen tubing and connectors took longest to put together (p < 0.05). Consultants and senior registrars performed no better than senior house officers and registrars (p > 0.05). In the second part of the study we tested four anaesthetic systems which the survey revealed might be chosen for emergency transtracheal ventilation. These were: a simple length of oxygen tubing; a T‐piece system; a Bain system; a jet injector. All had the appropriate connectors. The oxygen flow was measured through a 14 G venous‘transtracheal’cannula on depression of the oxygen flush device on a standard Boyle's M anaesthetic machine. The jet injector was connected to the high pressure outlet. This device delivered the highest flow, 43 l.min ‐1 and was the only system capable of ventilating a trachea/lung model. The T‐piece system, and the one constructed from oxygen tubing, delivered flows of 12.7 and 12.0 l.min ‐1 , respectively, whereas the Bain system delivered only 4.7 1.min ‐1 . We conclude that, except for jet ventilation, none of the systems chosen, using equipment available in the anaesthetic room, would be likely to achieve effective CO 2 elimination; at best they would provide oxygenation.