Emergency (CICV)

A patient with severe facial trauma has a completely obstructed upper airway. Mask ventilation fails, and the 3rd intubation attempt remains unsuccessful. Time is running out…


Find below an educational animation which shows the use of Ventrain in emergency ventilation.

A Cannot Intubate Cannot Ventilate (CICV) case like above is an emergency situation in which mask ventilation and intubation proves to be impossible due to a fully or partially occluded upper airway. Rapid access to the trachea is required, which should, according to most guidelines, be realized by means of a cricothyrotomy technique. A typical algorithm for these circumstances is displayed in the following figure.






Cannula cricothyrotomy

The algorithm implies that a CICV situation necessitates a choice between cannula and surgical cricrothyrotomy. The use of a cannula cricrothyrotomy as such would be preferable to the surgical or large bore equivalent, providing rapid access to the trachea with minimal trauma. However, conventional ventilation methods are not suitable to ventilate through small bore lumina in case of fully or partially obstructed airways. These methods are only able to remove gas by passive expiration through the small bore lumen, which is a too slow process. The result is insufficient oxygenation and enhanced risks of air trapping and developing complications such as barotrauma.

Ventrain is the solution in this life-threatening situation without the need of a surgical procedure. It contains the patented EVA (Expiratory Ventilation Assistance) technology, which makes it possible to actively remove gas from the lungs. This makes Ventrain the first ventilation device to enable complete and safe ventilation through a small bore lumen in cases involving a fully or partially obstructed upper airway.


Advantages of expiration by suction during emergency situations:

  • enables minimal invasive ventilation;
  • full ventilation: oxygenation and CO2 removal;
  • minute volume up to 7 L/min;
  • possibility for side-stream capnometry (this functionality is not available in the USA).

Adults and emergency

The Ventrain Emergency kit is the solution for emergency situations involving adult patients. It is an all-in-one package containing the Ventrain ventilation device and the Cricath needle cricothyrotomy catheter.

In case of a critical but not fully obstructed airway, Ventrain can also be used in combination with a small bore endotracheal tube (ID 2-3 mm), e.g. as an intubating introducer or tube exchange catheter. Ventrain is therefore also available without the cannula cricothyrotomy set.

Pediatrics and emergency

Ventrain can also be used in emergency situations in pediatrics. Due to the flexible tissue of pediatric patients, we are reluctant to suggest a cricothyrotomy for this patient group. We therefore recommend the use of an airway exchange catheter or an intubating introducer (ID = 2-3 mm) in pediatric cases. Once the airway is secured, connect Ventrain to the catheter for effective and safe ventilation.

More information

For more information and user reports, see the following links:


©2016 Ventrain, Cricath, Tritube and the EVA technology are registered trademarks of Ventinova Medical B.V. All rights reserved.


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