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TTJV, occasionally referred to as “needle cricothyroidotomy,” involves the insufflation of high‐pressure oxygen via a large‐bore intravenous type catheter (16 gauge or larger) inserted through the cricothyroid membrane. This technique requires 50 psi oxygen equipment capable of delivering oxygen at >50 L/min through a catheter. This is equivalent to “wall” oxygen pressure. TTJV cannot successfully be performed using conventional BVM equipment or a standard 25 L/min flow meter.

While TTJV has many theoretical limitations, the clinical implications remain unclear. For example, because TTJV primarily facilitates oxygenation, most clinicians assume that the technique can be used only for a short time. However, extensive data underscore the utility of the technique for prolonged periods [59, 60]. A 16‐gauge catheter with a flow rate >50 L/min and a ventilatory rate of 20 breaths/min can deliver a tidal volume of 950 mL [61, 62]. Aspiration is also a concern, but only limited data clinically quantify this problem [63]. EMS personnel may also use a properly placed jet ventilation catheter to help convert to an open cricothyroidotomy.

Figure 3.10 Cricothyroidotomy.