Midwife performs emergency tracheotomy on choking boyfriend

Isak Bester says he was essentially a goner so there was nothing to lose by Sarah Glass performing the tracheotomy. Photo / Warren Buckland

Midwife uses stanley knife to cut open airway for choking boyfriend.

A woman performed an emergency tracheotomy on her choking boyfriend at a barbecue with friends - using a stanley knife from the shed.

Isak Bester and his girlfriend, Sarah Glass, were enjoying a barbecue at a farm near Waimarama Beach, Hawke's Bay, last month when he started choking on a piece of steak.

Friends frantically slapped his back and attempted the Heimlich manoeuvre but Bester lost consciousness.

Glass, a midwife, did the unthinkable and grabbed a knife for an impromptu operation.

"A friend raced and grabbed a Stanley knife blade from the workshop and I cut into his throat just below his Adam's apple," Glass said.

"I didn't find it frightening - it was just the next thing that had to happen if we were going to keep him with us."

The actions have been praised as "heroic" by a medical expert who said most paramedics would only perform the procedure once or twice in their careers.

University of Otago Professor of Emergency Medicine Michael Ardagh said it should only be used as an absolute last resort - even by doctors.

For Glass, 45, it was the moment of last resort.

Bester turned purple, then passed out. His heart stopped.

"At that point she said there was no pulse or nothing," Bester said.

"She couldn't see me die and asked for a knife."

Glass said she told her friends, several of whom were medical professionals, she was going to cut Bester and later discovered some were thinking the same thing.

"I then - this is a bit gross - put my finger in his trachea to try to see if there was anything blocking the airway going down so I had to fish that out."

In a stroke of fortune, Glass had a home birth kit at hand with an oxygen tank, which she and the couple's friends used to keep oxygen flowing to Bester's brain.

Bester, manager of the Hastings crematorium and cemetery, said he was "way under" for a good two hours. Doctors said he would have brain damage or organ failure if he lived - if it weren't for the oxygen supply.

The 50-year-old remained in an induced coma for nearly three days and was kept in hospital for another week.

Now, just over a month later, the father-of-two is on the road to a full recovery.

The life-saving actions have been praised as "heroic" by a medical expert.

"I've still got a cut in my throat but other than that I'm good. All the tests are good," he said.

Ardagh praised Glass's quick thinking and calm response but said he certainly wouldn't recommend it because "a lot can go wrong".

"For her to pick up a knife and do this is absolutely fantastic and quite heroic," Ardagh said.

The procedure, also known as a cricothyroidotomy, was relatively easy if you knew what you were doing. "But it's not easy if you don't."

"When everything else has been tried and the person is going to die for want of an airway - the person is on death's door and has lost their pulse.

"I think everything lined up in this situation. There was absolutely no other choice," Ardagh said.

"In this case, in my view, she had no other option. I think it's fantastic."

He said medical professionals had other options available that they would try first so most emergency doctors or paramedics would only perform such a procedure a couple of times in their career.

Glass said she knew that they were a long way from help and "without getting oxygen in he was dead anyway".

"His heart was no longer beating on its own and we had nothing to lose."

She said her midwife training hadn't prepared her for such an experience but she had read a book titled The Worst-Case Scenario Survival Handbook.

"I think that's where I read it. It's the only place I can think I might have seen it ... and it worked."

Bester said he was a "very lucky man" and was pleased to be back at work already.

"Obviously for her to make the decision to cut - people don't do that sort of stuff.

"That decision and all the others who were there giving CPR all that time; they just never gave up.

"There's a lot of things that could have gone wrong but there was no pulse, I was in cardiac arrest.

"I was a goner so there was nothing to lose."