What is transcricoidal puncture

   I. Conceptual transplantation method In clinical research, many inventions are related to conceptual transplantation. The so-called concept transplantation method refers to the transplantation of concepts from other fields to this field in clinical thinking. For example, “cocktail therapy” is the concept of treating AIDS, which means that several different drugs are used together in different proportions.  This concept is used in cardiopulmonary resuscitation, where several resuscitation drugs are put together and used in combination, such as the “triple shot” used in the past, which is a “cocktail therapy”. In hypertension treatment, several antihypertensive drugs are combined in different proportions, which is also a kind of “cocktail therapy”.  Transcricoidal puncture is a common technique for endotracheal anesthesia in anesthesiology departments, and we transferred this concept to prehospital CPR emergency drug delivery and invented the syringe described below.  II. Problems of prehospital emergency drug delivery methods Clinical practice proves that the effect of CPR without drug coordination is poor. The main obstacle to the effective implementation of drug resuscitation in on-site CPR is the drug delivery method and equipment. Currently, the main drug delivery methods for CPR are intravenous, intratracheal and intracardiac injection. Among them, intravenous injection is the main route of CPR, and intracardiac injection is basically no longer used due to a variety of serious complications.  The effectiveness of cardiopulmonary resuscitation via tracheal administration has been clinically proven to be reliable, but its practical use is mostly limited to occasional intubation of patients in hospitals. For patients with cardiac or respiratory arrest outside the hospital in public settings, the lack of effective devices for endotracheal administration makes simultaneous drug resuscitation almost impossible.  The design of a trans-cricothyroid puncture endotracheal drug delivery resuscitation needle To this end, we designed a trans-cricothyroid puncture rapid drug delivery resuscitation needle, see Figure. The rapid drug delivery resuscitation needle consists of two major components: the syringe and the needle.  The differences between this syringe and the common syringe are: (1) the rear end of the syringe is replaced by a closed high-pressure air chamber with a pressure indicator instead of the conventional manual pressurized piston; (2) the front end of the syringe is equipped with a flexible injection activation button to control the switch of the drug storage chamber; (3) the drug storage chamber can be filled with a quantitative amount of common resuscitation drugs, such as epinephrine, norepinephrine, isopropyl-epinephrine, dopamine, aminophylline, aminoglycine, and doxycycline. Dopamine, aminophylline, glucocorticoids, hemostatic drugs, etc.  The needle differs from ordinary needles in the following ways: (1) the needle is long and sharp to facilitate the puncture of the cricothyroid membrane; (2) the front end of the needle is surrounded by a number of small holes to facilitate the rapid release of drugs; (3) the rear end of the needle is equipped with a knob that can be moved up and down to control the depth of puncture.  The resuscitation needle is kept in a sterile bag and can be equipped in vehicles, ships, shopping malls, tourist attractions and other public places.  Fourth, the use of transcricoidal puncture endotracheal drug administration resuscitation needle The resuscitation needle is suitable for any emergency occasions outside the hospital, and has obvious advantages compared with the conventional syringe.  The disadvantages of conventional syringes for puncture are: (1) the operation is very specialized and can only be performed by medical personnel with professional medical training; (2) it can generally only be performed in the hospital, and it is difficult to perform on-site CPR outside the hospital; (3) the operation steps are tedious and time-consuming, and the amount of injected drugs is not easily controlled and easily contaminated.  The rapid drug delivery resuscitation needle via cricothyroid puncture solves these problems. On any occasion when a patient with cardiac or respiratory arrest is encountered, any witness, while performing chest compressions and artificial respiration, removes the rapid drug delivery resuscitation needle, opens the sterile bag, quickly adjusts the puncture depth according to the patient’s age, fatness and thinness, punctures the trachea from the cricothyroid membrane, and presses the injection activation button. Continue chest compressions, artificial respiration, if necessary, you can again choose to use the tracheal drug delivery resuscitation needle until the patient’s condition is stable or sent to the hospital for resuscitation.