The Portex PCK kit uses:

• A wide-bore cannula-over-needle/dilator technique
• A blunt, 6 mm internal diameter cannula, pre-loaded over a dilator and needle
• A cuffed cannula

Skin incision prior to insertion is recommended by manufacturer.

The needle hub contains a red, springloaded indicator flag (Fig 1). The very tip of the needle is blunt.

When pressure is applied to the tip of the needle, the red flag indicator appears. This initially indicates contact with the soft tissues or cricothyroid membrane. Entry into the hollow trachea causes release of the pressure on the needle tip and the indicator flag disappears. When contact is made with the posterior wall of the trachea, the red flag re-appears. The device should be withdrawn slightly. The needle is then removed and the cannula advanced over the introducer.

Fig 2 shows a video of this procedure.

Select Play to watch the video.

The Difficult Airway Society do not recommend these devices for emergency FONA. Their use in the CICO situation should be limited to experienced clinicians who use them in routine clinical practice.