Emergency airway puncture

Definition

Emergency airway puncture is insertion of a hollow needle into the airway done to treat life-threatening choking.

Alternative Names

Needle cricothyrotomy

Description

In an emergency situation, when someone is choking and all other efforts to assist with breathing have failed, a hollow needle or tube can be inserted into the throat, just below the Adam's apple (cricoid cartilage).

In a hospital setting, a small cut in the skin is made before inserting the needle.

Why the Procedure Is Performed

A cricothyrotomy is recommended as an emergency procedure to relieve an airway obstruction until surgery can be done to place a breathing tube (tracheostomy).

Risks

Risks for any surgery are:

• Bleeding
• Infection

Additional risks include trauma to the voice box (larynx), thyroid gland, and esophagus, and perforation (tearing) of the lungs and other body parts in the chest, leading to a collapsed lung and air collecting around the heart.

Before the Procedure

After the Procedure

Emergency airway puncture (cricothyrotomy) can be quite effective in temporarily relieving an airway obstruction, but it must quickly be replaced by a more effective means of ventilation.

Outlook (Prognosis)

What happens will depend on the cause of the airway obstruction and how quickly the person receives a better means of ventilation.

See: Tracheostomy

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References

Goldenberg D, Bhatti N. Management of the impaired airway in the adult. In: Roberts JR, Hedges JR. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2004: chap 106.

Rubin M, Sadovnikoff N. Pediatric airway management. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004: chap 15.

Thomas SH, Brown DFM. Foreign bodies. In: Marx J. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo: Mosby Elsevier; 2006: chap 57.