Transtracheal jet ventilation (TTJV) is rarely used, but remains an important option in the cannot intubate, cannot ventilate patient, especially if supraglottic ventilation devices (laryngeal mask airway, esophageal-tracheal combitube, perilaryngeal airway, or laryngeal tube) have failed or cannot be inserted. After oxygenation and ventilation with TTJV are established, the airway nonetheless remains unprotected. If the patient cannot rapidly be awakened to resume spontaneous ventilation, or if this is contraindicated, an endotracheal tube (ETT) should be placed to guarantee patency of the airway and protect the patient from aspiration of pharyngeal or gastric contents.

The combination of these two techniques is supported by anecdotal evidence.¹,² The pressures generated by TTJV may serve to stent open the airway, facilitating fiberoptic bronchoscopy (FOB), while permitting ongoing ventilation during the procedure.¹