Difficult airways: a reliable “Plan B”

Abstract

Percutaneous transtracheal jet ventilation (PTJV) is an accepted method of rescue ventilation following unsuccessful attempts to secure the airway through conventional methods. Pre-emptive use of PTJV in the difficult airway has also been described as using either a specifically designed jet ventilation catheter, or other cannulae, such as a central venous catheter (CVC). We report on the insertion of a single-lumen CVC to establish a means for PTJV or oxygen insufflation prior to induction of general anaesthesia in an 18-year-old man. He had an anticipated difficult airway and potentially difficult rescue airway access, having been booked for biopsy of neck masses and formal tracheostomy.