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Samuel Du Bose Ravenel, MD
Moses H. Cone Memorial Hospital Greensboro, NC

JAMA. 1986;255(21):2898-2899.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

In response to a question about the status of transcutaneous intratracheal epinephrine injection in advanced cardiac life support,¹ Drass suggests that administration by cricothyroid puncture rather than by endotracheal tube has disadvantages that dictate "limited application." He cites the need to halt cardiopulmonary resuscitation to perform the cricothyroid puncture, the necessity of teaching the skill to prehospital personnel, and the risk of hemorrhage with resultant airway compromise.

My experience in performing cricothyroid punctures in pediatric and adult patients for diagnostic purposes suggests that the risks and disadvantages may not be significantly greater than those associated with administration through endotracheal tube.

From personal experience with both procedures, the skill required for successful needle puncture through the cricothyroid membrane seems less than that required for successful endotracheal intubation in an emergency situation. The time required for needle puncture and rapid delivery of medication is minimal, particularly in the . . . [Full Text PDF of this Article]

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