see also: [[Tracheostomy]], [[Airway]] #paeds #resus see: [Dunn surgical airway techniques](x-devonthink-item://01D60E4F-BEE3-4976-8BBD-4FB7378870F6), [Ventilation through a straw 2022](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346197/) - [bookends link](bookends://sonnysoftware.com/ref/DL/16992) used for **needle cricothyroidotomy** - preferred in small children - can provide oxygenation for up to 45 minutes - not sufficient for normal *ventilation* - risks of barotrauma in complete obstruction because expiration needs to happen through the partially-obstructed upper airway - in this case, preference for [[Tracheostomy|scalpel front of neck access]] > **O2 flow rate** > - 15L/min adult > - 1L/min/year of age for children # Connection techniques for 16g cannula ## 1. 10 mL syringe → O2 tubing - 10mL syringe barrel with plunger removed - jam green O2 tubing into barrel and connect to cannula wiht 3-way tap - open all taps and turn O2 on and occlude side tap to perform jet insufflation: ![[Pasted image 20240801195527.png]] ## 2. BVM → size 8 ETT blue adaptor - connect BVM to size 8 ETT adaptor (blue) which is jammed into barrel of 3mL syringe and connected to the cannula # complications | category | complication | | ------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------- | | - unsuccessful catheter placement<br>- OR obstruction after placing | inability to ventilate, s/c emphysema | | barotrauma | s/c emphysema, pneumomediastinum, pneumothorax, pneumatocele of larynx | | damage to adjacent strctures | - posterior tracheal laceration or perforation<br>- esophageal perforation<br>- mediastinitis<br>- vocal cord injury<br>- laryngeal injury and/or laryngospasm | | excessive bleeding | - haematoma with extrinsic or intrinsic airway narrowing | | infection | cellulitis and abscess<br>osteomyelitis of c-spine |