Airflow efficacy of ballpoint pen tubes: a consideration for use in bystander cricothyrotomy

Emerg Med J. 2010 Apr;27(4):317-20
doi: 10.1136/emj.2008.069294

David Owens [1], Ben Greenwood [1], Alistair Galley [1], Alun Tomkinson [2], Sarah Woolley [3]

[1] Princess of Wales Hospital, Bridgend, Wales, UK
[2] University Hospital of Wales, Cardiff, Wales, UK
[3] Bristol Royal Infirmary, Bristol, England, UK

Correspondence to David Owens, Princess of Wales Hospital, Bridgend, Wales CF31 1RQ, UK

Accepted 8 July 2009

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.

http://emj.bmj.com/content/27/4/317.abstract