ACUTE obstruction of the upper airway from trauma, a foreign body, or laryngospasm may cause death in a few minutes. Rapid institution of a satisfactory airway may be lifesaving. Proper instruments to perform endotracheal intubation, tracheostomy, or bronchoscopy may not be available within the critical time. The attending physician may not be expert in performing these procedures, particularly for an agitated, mobile, gasping patient. Ingenious instruments for performance of rapid tracheostomy have been used,1 but they have not gained wide acceptance and are not available in most hospitals. Their use has resulted in a few fatal complications.2-4 There appears to be a need for a simple, safe, available, and rapid method of creating a satisfactory airway during acute obstruction of the upper respiratory tract. Theoretically, temporary needle tracheostomy could fulfill these criteria until endotracheal intubation or tracheostomy was expertly performed. We have evaluated the physiologic effects of needle