Shukla Rajiv, Sahu Seelora, Kant Shashi, Dubey K P, Swain Amlan, Uppalapati Vamsi K
Department of Anaesthesia and Critical Care, Tata Main Hospital, Jamshedpur, Jharkhand, India.
Chief of Medical Indoor Services, Department of Otorhinolaryngology, Tata Main Hospital, Jamshedpur, Jharkhand, India.
J Family Med Prim Care. 2020 Jan 28;9(1):439-441. doi: 10.4103/jfmpc.jfmpc_865_19. eCollection 2020 Jan.
To report and discuss a novel way of managing the airway in a difficult case of anterior tracheal wall disruption caused by blunt trauma to the neck.
Tracheal injury resulting in laceration of the windpipe may present with either one or many of the multitude of problems such as respiratory distress, hoarseness of voice and subcutaneous emphysema. Most often it requires surgical intervention.
We hereby present the novel use of a mini-tracheostomy kit as an aid in the cannot-intubate-cannot-ventilate situation of a 30-year-old patient presenting with severe features of blunt tracheal injury. The airway was established critically with the use of the mini-tracheostomy kit in a "cannot-intubate-cannot-ventilate" situation during surgical tracheostomy and a potentially disastrous cardiorespiratory arrest situation was averted.
Timely presence of airway equipment, adequate preparation, a willingness to innovate and a team approach are of paramount importance in dealing with difficult airway situations that are presented in myriad and complex ways.
The stylet of mini-tracheostomy kit can be used in emergent airway management especially in clinical situations mimicking ours specifically as a guide for insertion of the standard tracheostomy tube.
报告并讨论一种处理颈部钝性创伤导致气管前壁破裂这一困难病例气道的新方法。
气管损伤导致气管撕裂可能会出现多种问题中的一种或多种，如呼吸窘迫、声音嘶哑和皮下气肿。大多数情况下需要手术干预。
我们在此介绍在一名30岁钝性气管损伤严重患者出现“无法插管-无法通气”情况时，新型迷你气管切开套件作为辅助工具的应用。在手术气管切开过程中，在“无法插管-无法通气”的情况下，使用迷你气管切开套件成功建立气道，避免了可能导致灾难性后果的心肺骤停情况。
在处理以各种复杂方式呈现的困难气道情况时，气道设备的及时配备、充分准备、创新意愿和团队协作至关重要。
迷你气管切开套件的管芯可用于紧急气道管理，特别是在类似我们这种临床情况中，可作为插入标准气管切开导管的引导。
