User:Mr. Ibrahem/Percutaneous translaryngeal ventilation

Percutaneous translaryngeal ventilation (PTLV), also known as needle cricothyrotomy, is the delivery of oxygen to the lungs through an over-the-needle catheter inserted through the skin of the neck into the trachea. It is typically done in young children, instead of surgical cricothyrotomy, in a cannot intubate cannot ventilate situation. What counts as young varies from under 5 to under 12 years old. It is also used as part of anesthesia for laryngeal surgery.

The procedure involves placing a large needle through the cricothyroid membrane (CTM) directed towards the lungs. Once in place the catheter is slid off the needle into the airway. Oxygen is then delivered by high pressure jet ventilator or bag valve mask. If using a bag valve mask intravenous tubing and a 2.5 endotracheal tube adapter is used to connect the components. Oxygen is briefly given with great time provided for air to exit the lungs.

The catheter may be sutured or tied into place. Capnography can be used to verify it is in the correct place. Complications may include catheter misplacement or blockage, bleeding, subcutaneous emphysema, pneumothorax, pneumomediastinum, vocal cord injury, esophageal perforation, and laryngeal cartilages injury. Over time respiratory acidosis may develop. As the procedure is rarely performed, having the equipment preprepared and doing simulation is important.