I read with interest the case report number 2013-10 in the October NEWSLETTER by Dr. Dutton, regarding use of a knife or needle in emergency airway management. The only reason there is any debate about this matter is that most anesthesia personal have no real-life experience with either technique, and hence have no way to judge which is better. However, in a life-threatening airway obstruction, there is no question which is better. An emergency cricothyrotomy is much quicker, easier, safer and more effective than any needle-based technique. I can state with confidence that there is no place in emergency airway management for needle-based attempts to establish ventilation. It should be deleted from the ASA Difficult Airway Algorithm. I have participated in seven cricothyrotomies in emergency airway situations, and all of the patients left the hospital without any neurological injury or complications from the cricothyrotomy. The risk-benefit ratio is markedly in...

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