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Emergency tracheal catheterization for jet ventilation: a role for the ENT surgeon?

Published online by Cambridge University Press:  08 March 2006

T D A Standley
Affiliation:
Department of Anaesthetics, Addenbrookes Hospital, Cambridge, UK.
H L Smith
Affiliation:
Department of Anaesthetics, Addenbrookes Hospital, Cambridge, UK.

Abstract

Stridor causing respiratory failure is an ENT and anaesthetic emergency requiring prompt management to secure a clear airway. We describe a case of subacute partial upper airway obstruction due to a large laryngeal carcinoma in an 81-year-old male resulting in respiratory failure. The patient became apnoeic after gaseous induction of general anaesthesia, and after two failed intubation attempts an emergency transtracheal airway catheter was placed by the surgeon under direct vision below the cricothyroid membrane, as this had tumour involvement. The patient was subsequently manually jet-ventilated with ease until a formal tracheostomy was made. Where difficulties with tracheal anatomy are encountered due to the presence of pathology, the insertion of a temporary airway catheter for jet ventilation by the surgeon can buy valuable time and be life-saving.

Type
Clinical Records
Copyright
© 2005 Royal Society of Medicine Press

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