Failed emergency transtracheal ventilation through a 14-gauge intravenous catheter

Abstract

We encountered two patients who could be neither ventilated nor intubated after induction of anesthesia. In both cases, transtracheal ventilation failed after emergent cricothyroid management puncture with a 14-gauge intravenous (IV) catheter. In the first case, two catheters placed in rapid succession kinked, preventing gas exchange. In the second case, absence of a plunger on the needle-over-catheter assembly prevented confirmation of intratracheal placement. Both patients required emergent tracheal access by the surgeon. We suggest that transtracheal ventilation via standard IV catheters as a primary emergent rescue technique be reassessed.