Parker Jun D
Department of Anaesthesia, Portland District Health, 141-151 Bentinck Street, Portland, Victoria 3305, Australia.
School of Clinical Medicine, The University of Queensland, St Lucia, Queensland, 4072, Australia.
Case Rep Anesthesiol. 2021 May 8;2021:8815376. doi: 10.1155/2021/8815376. eCollection 2021.
A 94-year-old female presented to the emergency department with acute expiratory stridor. In the absence of an otorhinolaryngologist, an urgent laryngoscopy was performed using a flexible bronchoscope by an anaesthesiologist in the emergency department leading to a change in management. Subsequent radiographs confirmed severe tracheal compression from megaoesophagus secondary to achalasia as the cause of acute airway obstruction. Use of flexible bronchoscope as a diagnostic tool by an anaesthesiologist to evaluate a patient presenting with signs of acute airway obstruction may lead to a safer and more careful airway management planning. Suggestions are also made regarding establishment of emergency surgical airways when conventional approaches fail.
一名94岁女性因急性呼气性喘鸣到急诊科就诊。由于没有耳鼻喉科医生,急诊科的麻醉医生使用柔性支气管镜进行了紧急喉镜检查,从而改变了治疗方案。随后的X线片证实,贲门失弛缓症继发的巨食管导致严重气管受压,是急性气道梗阻的原因。麻醉医生使用柔性支气管镜作为诊断工具来评估出现急性气道梗阻体征的患者,可能会带来更安全、更谨慎的气道管理规划。文中还针对传统方法失败时建立紧急手术气道提出了建议。