There’s a little MacGyver in every good paramedic and may be required for the Needle Cricothyrotomy when the commercially available jet ventilation kit is not available. The attached link provides a few examples.
I vaguely remember an old black and white television movie (ask your parents or grandparents what black and white TV is) where some kind of medical emergency happens on an airplane, a physician is onboard and makes an incision with a pocket knife presumably in the cricothyroid membrane and then unscrews a ball point pen and places the bottom of the barrel into the incision and the patient is saved, but the ventilation of that patient must be by magic.
Presentations on the needle cric usually discuss the jet ventilation kit which may not be available. It is easier and safer than an open or surgical cric, but there needs to be a way to ventilate the patient, not just to provide a very small airway. Next time you have one of those plastic coffee stirrers or mixed drink stirrers try breathing through it; be careful, it will probably produce a vagal response. Even if you can get air into the patient, it doesn’t have much of a chance for exhalation.
Look for some of the airway options between the surgical and needle cricothyrotomy, such as the QuickTrach Emergency Cricothyrotomy Kit or VBM Medical Quicktrach II with cuff; your patient may be able to thank you at a later date.
Learn more about ventilation with our ALS L-1 course!
L. “Russ” Ruszczyk, NRP, ASEMS