If you want to be prepared to operate on someone’s cricothyroid membrane in an emergency, consider always carrying a pen — but perhaps not just any pen. Consider this:
“Airflow Efficacy of Ballpoint Pen Tubes: A Consideration for Use in Bystander Cricothyrotomy,” Owens D, Greenwood B, Galley A, Tomkinson A, Woolley S., Emergency Medical Journal, 2010 Apr;27(4):317-20. The authors, at Princess of Wales Hospital, Bridgend, Wales report:
OBJECTIVE: To examine the suitability of commonly available ballpoint pens as a substitute emergency tracheostomy tube.
METHODS: Commonly available ballpoint pens were examined and compared against two standard cricothyroidotomy sets. The pens were evaluated for dimensions, speed of construction of a temporary tracheostomy tube and airway resistance with differing flow rates.
RESULTS: Internal diameters of the pens varied considerably. Time taken to construct a temporary tube ranged from 3 to 170 s, and in the majority of pens the airway resistance increased dramatically as the airflow rate increased.
CONCLUSION: Contrary to popular belief, the majority of ballpoint pens appear unsuitable for use as a substitute tracheostomy tube. In this study only two pens fulfilled the criteria for use: the Baron retractable ballpoint and the BIC soft feel Jumbo.
(Thanks to investigator Johnty Wang for bringing this to our attention.)