Fast-forward to 40 minutes – soldier with severe maxillofacial trauma has scalpel-finger-tube cricothyroidotomy performed under IM ketamine in the back of a Blackhawk
One of the perennial debates in medicine is the choice between a surgical technique versus a needle technique for a can’t intubate/can’t ventilate situation.
The video below shows Minh Le Cong demonstrating some approaches to needle cricothyroidotomy. What struck me was the how simple and fast the ‘minimalist’ approach is , whereby oxygenation is provided (very rapidly) by simply pressing the oxygen tubing up against the cannula hub – no furious hunting for suitable connection devices!
This is worth seeing, it looks like a very useful ‘get out of jail’ card! In the prehospital setting it could be a bridge to further attempts at laryngoscopy (in the podcast above Minh describes several occasions where this has occurred in a retrieval setting) or a more definitive surgical airway prior to transport.