This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Mary Fran Hazinski, RN, MSN
Vanderbilt University Medical Center Nashville, Tenn American Heart Association

Leon Chameides, MD
University of Connecticut Health Center Farmington American Heart Association

JAMA. 1993;269(20):2626-2627.

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

In Reply.

—The phrase from the 1992 PALS guidelines, "This technique enables effective support of oxygenation...," is challenged as unreferenced and inaccurate. However, Drs Burke and Mellick have omitted the subsequent qualifying phrase, "although carbon dioxide elimination may be suboptimal."

The statement is referenced at the beginning of the paragraph.¹ In a study of dogs weighing 21 to 30 kg, the PaO₂ was consistently maintained above 130 mm Hg during 30 minutes of manual ventilation via percutaneous needle cricothyrotomy.¹ The paucity of pediatric data is acknowledged in the guidelines: "Percutaneous needle cricothyrotomy has only been effective in small animals. [reference]. However, only anecdotal reports of this method of ventilation in children have been published so further evaluation is needed."

The two clinical review articles cited by Burke and Mellick confirm that needle cricothyrotomy may not support oxygenation and ventilation in adults. As Yealy et al observed, "The . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?