To the Editor.—
The article by Attia et al (234:1152, 1975) describes the use of a 14-gauge catheter inserted percutaneously into the trachea to deliver oxygen to a patient with severe laryngeal obstruction. While referring to earlier animal experiments, the authors did not credit Jacoby et al1 for first describing this method of emergency oxygenation in humans. A more contemporary description of the use of the technique, which included mechanical ventilation as well as oxygenation, was provided by Jacobs.2The authors also did not emphasize that mortality and major morbidity have been reported with procedures utilizing cricothyroid membrane or tracheal puncture.3 We recently encountered a patient in whom severe airway obstruction due to extensive subcutaneous emphysema followed cricothyroid membrane puncture performed as an aid to tracheal intubation.4,5Transtracheal ventilation is an important technique in emergency medicine; however, it is not without major complications. Like any other procedure,
Craig DB. Transtracheal Ventilation. JAMA. 1976;235(19):2082. doi:10.1001/jama.1976.03260450014016
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