[swatsurgeon]

I'm back........
overall management:
is the patient moving air??? yes, but with great difficulty.....
this is the one time I remove foreign bodies....yes, I lose the photo op but the glass/object is obstructing the airway and if you try to pass an ETT, it would rip the balloon everytime.

You are correct, it is located right through the crico-thyroid membrane. He did the work for you, push the ETT right through the wound, If it is difficult, try oral intubation, or the acid test, occlude the wound with something (vasaline gauze or the like, hold tight pressure and see if he is able to maintain his airway....not my first move but if you have no other choice you could see if he flys on his own....safest thing is a tube through the injury, which is what I did with him totally awake to assist in his own respirations. Once the tube was in place he stayed awake and wrote us a note!!! Did inject some lidocaine at the incision site after that for comfort and changed him to a trach tube, #6 cuffed, then scoped him to look for other injuries to posterior wall, and esophagus and locally explored the neck in the OR for vascular injuries (all negative).