Low minute volume rescue oxygenation after cannula cricothyroidotomy in the can't intubate can't oxygenate scenario

Abstract

Editor—The recent study by Laviola and colleagues1 highlights that in a can't intubate can't oxygenate (CICO) scenario dynamic hyperinflation is possible if high minute volume ventilation is attempted via a small bore (<3 mm) cannula. As proponents of the Royal Perth Hospital (RPH) CICO approach, we were interested to use the study to reflect on the jet oxygenation strategy that we recommend after narrow-bore cannula cricothyroidotomy/tracheotomy.2 The RPH strategy (Table 1) has been developed over many years using live ovine models with apnoea involving complete and partial upper airway obstruction and variable cardiorespiratory pathology.