Transtracheal jet ventilation

Transtracheal jet ventilation (TTJV), also called needle cricothyrotomy, is a simple, safe and effective technique for ventilating apnoeic lungs, electively or in an emergency. No patient should suffer hypoxic injury as a result of failure to ventilate the lungs without a competent attempt at TTJV having been made. Failure to ventilate still causes death under anaesthesia. An incidence of about 1/10,000 is quoted for failure to intubate associated with failed mask ventilation at anaesthesia. Using dedicated equipment, such as the Ravussin Jet Ventilation Catheter, minimizes the chances of apparatus-related failure. Little experience is necessary; however, familiarity encourages earlier use in an emergency and allows a more confident approach to the difficult airway when the technique is available as a backup, in case of failure of the first strategy for management of the patient's airway. A number of centres worldwide use TTJV electively for peroperative ventilation. A complete TTJV system consisting of cannulae and high pressure oxygen injector should be available in all areas where anaesthesia is administered or where unconscious patients may be admitted.