He was subsequently weaned from mechanical ventilation over 48 hours, and transferred from the medical intensive care unit with a tracheostomy collar to the ward. PTJV is not popular in the medical intensive care unit where the majority of endotracheal intubations in critically ill patients are managed by non-anesthesiologists. Familiarity with PTJV for immediate oxygenation during difficult or failed intubation can be life saving. The pressurized oxygen can be delivered directly from the wall outlet. Inspiration is achieved by insufflation of pressurized oxygen with the jet ventilator.
Expiration is passive secondary to the elastic recoil of the lungs and the chest wall.
Air escapes through the glottic aperture creating a jet of bubbles at the oropharyngeal structure. This offered two advantages in the present case. First, escape of the high-pressurized air prevented the closure of the glottic aperture and secondly, jet of bubbles at the oropharyngeal structure guided the bronchoscope to the glottic aperture. The most important benefit of PTJV in our case was immediate availability of oxygenation and ventilation. This was followed with an attempt of direct laryngoscope intubation that resulted in esophageal intubation.