Hi Karie - I wanted to send you my quick thoughts on your post - Moral of the story, after 25 or so years of playing peds transport, I've honestly ever only met one peds transport nurse who not only read about this procedure, but actually performed it on a kid (& it worked) - What I've seen most commonly described in courses for kids involves the 14g IV catheter, end of a 3.0 ETT, and bag away - However, few things come into play - research that I've seen says 1) it is better than nothing in kids that are CICO (can't intubate, can't oxygenate), i.e. they are going to quickly die without an airway 2) it buys you some time - how much... depends - but what I've read seems to be more or guess about 30 minutes or so - you can get some air (o2) in, but trying to exhale through a cocktail straw doesn't work so well & the co2 levels quickly become way too high - 3) surgical crics - though needle cric is most commonly taught for kids, there is literature/case studies out there about non-ENT, i.e. ER docs, doing surgical crics on kids & it worked well - but again, pretty much every course/book that I've come across, seems to recommend the needle cric in kids - 4) in our peds skills, aka. peds pig procedure labs, we do this procedure, but issues quickly are noticed by the attendees with kinking of the IV catheter (it's meant to go in a vein, not a flesh filled neck), 2) it's really hard to bag through a cocktail straw, & 3) it's incredibly easy for the catheter to get dislodged, i.e. fall out - again, in talking to the only nurse I've met who actually did the procedure on a kid, I asked her, "how did you secure it?" - her reply, "I held it like the kid's life depended on it" (because it did)
there are some manufacturers that offer "jet insufflation" devices for kids & big people, but I've not come across an ER that had them - in talking with some anesthesia colleagues about this procedure for our labs, they recommended: https://ventinovamedical.com/products/ventrain/ (no disclosures - they just recommended the device) - in looking at research for the device, it's mainly used in adults, but there is research showing it can be used in kids as well - I've heard of other places using percutaneous "cric kits" in kids, but my understanding in talking with people who have used them, has been they have not had great experiences (again, no disclosures, conflicts, etc.)
hope this helps
cheers
scott
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Scott DeBoer RN,MSN,CPEN,EMT-P
Founder
Pedi-Ed-Trics Emergency Medical Solutions
Reunion, Florida
888-280-PEDS (7337)
Scott@PediEd.com------------------------------
Original Message:
Sent: 09-18-2024 05:31 PM
From: Karie Pearce
Subject: TTNV for Peds
Looking for information on what other facilities/agencies are teaching or using for TTNV(Transtracheal Needle Ventilation) supplies for peds patients. Does anyone have cases that needed this procedure they are willing to share? Thanks for sharing any info!
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Karie Pearce BSN;RN;CEN;CPEN;TCRN
kjpearce27@gmail.com
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