Li Ke-Xin, Luo Yu-Ting, Zhou Leng, Huang Jia-Peng, Liang Peng
Department of Anesthesiology, West China Hospital, Chengdu 610041, Sichuan Province, China.
Department of Anesthesiology, University of Louisville, Louisville, KY 40202, United States.
World J Clin Cases. 2021 Dec 6;9(34):10733-10737. doi: 10.12998/wjcc.v9.i34.10733.
Penetrating neck injuries require prompt recognition, diagnosis and management of critical airways. This case demonstrates an emergent situation that a "medical negligence" was avoided with the aid of end-tidal carbon dioxide (ETCO) waveform.
We report a case of malposition of the endotracheal tube into the right hemithoracic cavity for cervical knife trauma, resulting in pneumothorax. Tube placement was not confirmed during emergency airway management, and the patient was directly transferred to the emergency operation room. Assisted by ETCO and imaging examinations, the anesthetist timely noticed the absence of ETCO waveform and resolved this urgent situation before anesthesia induction.
This case emphasizes the necessity of ETCO waveform and/or X-ray confirmation of endotracheal intubation even in emergent situations.
穿透性颈部损伤需要对关键气道进行迅速识别、诊断和处理。本病例展示了一种紧急情况,即借助呼气末二氧化碳(ETCO)波形避免了“医疗过失”。
我们报告一例因颈部刀伤导致气管插管误入右半胸腔并造成气胸的病例。在紧急气道处理过程中未确认导管位置,患者被直接转运至急诊手术室。在ETCO和影像学检查的辅助下,麻醉医生及时发现ETCO波形消失,并在麻醉诱导前解决了这一紧急情况。
本病例强调即使在紧急情况下,ETCO波形和/或X线确认气管插管的必要性。