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Gregory Burke, MD; Larry Mellick, MD
Loma Linda (Calif) University Medical Center

JAMA. 1993;269(20):2626.

	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.

—We would like to advise you of an inappropriate recommendation concerning management of the pediatric airway. During a discussion of percutaneous needle cricothyrotomy for patients with severe facial trauma in the section "Miscellaneous Adjuncts to Airway Ventilation,"¹ the use of a largebore (ie, 14-gauge) over-the-needle catheter attached to a standard (3-mm) endotracheal tube adapter and a hand resuscitation bag is recommended. There is an unreferenced statement, "This technique enables effective support of oxgenation."

We believe that there is no evidence to support the effectiveness of this recommendation. In fact, there is significant published material suggesting that this technique will not support oxygenation and ventilation. In 1988, Yealy et al² demonstrated that ventilation through a catheter with a bagvalve setup is not effective unless one is using a minimal tube size of 3.5-mm internal diameter (ID).² Furthermore, these authors confirmed that if one uses a . . . [Full Text PDF of this Article]

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