Forget about saving a life by plunging a pen through the neck

(Reuters Health) - Few movie scenes create more drama than a character saving a dying person’s life by plunging a pen into his neck to open up his airway, but a new study from Germany suggests viewers shouldn’t try that trick at home.

Researchers had 10 people try to push ballpoint pens through the necks of fresh cadavers to create a passage to the airway. While all participants were able to break the skin, only one person was able to get to the airway.

The results show that people shouldn’t try something just because they read it or see it in the media, said Dr. Michael Kamali, chair of emergency medicine at the University of Rochester Medical Center in New York.

“We haven’t had anyone come into our department who tried to do this with a ballpoint pen, and I hope we don’t,” said Kamali, who wasn’t involved in the new study. “I don’t think the outcome would be too good.”

The procedure, formally known as a cricothyroidotomy, is used in emergency situations to establish airflow when more traditional methods won’t work due to trauma, inflammation or another blockage. But emergency personnel use scalpels and tubes, not pens.

While ballpoint pens are recommended by some medical textbooks as emergency breathing tubes, there was conflicting evidence on whether it would actually work, the researchers write in the Emergency Medical Journal, April 19.

For the study, Dr. Ulrich Kisser of Ludwig-Maximilian-University of Munich and colleagues tested three different types of ballpoint pens to see if they could be used as breathing tubes. Two pens made the cut, so to speak.

Next they had 10 people from different walks of life - lawyers, police officers and students - attempt to use the pens to perform a cricothyroidotomy on the bodies of 10 people who had died within the past two days.

Six of the participants punctured the neck too low and stabbed the thyroid gland. Three of the participants punctured the neck at the right spot.

Only one person was able to break the skin, ligaments and airway wall to establish airflow. For that person, it took more than 5 minutes, three attempts and “a lot of patience” and force. The person also caused damage to the neck and airway.

“A cricothyroidotomy just with a ballpoint pen is virtually impossible,” write the researchers. But they note that a dismantled ballpoint pen may be used as a breathing tube if another sharp tool is first used to cut through to the airway.

Kamali said people should always call 911 first if someone is having difficulty breathing.

“Trying to perform this without any medical type of experience would potentially lead to consequences and failure,” he said. “It’s something I would not recommended people take on.”


Emerg Med J 2016.