Two Endotracheal Tubes in One Trachea with a Traumatic Injury
Background. Traumatic airway injuries often require improvising solutions to altered anatomy under strict time constraints. We describe here the use of two endotracheal tubes simultaneously in the trachea to facilitate securing an airway which has been severely compromised by a self-inflicted wound...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2021/9912553 |
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| author | Andrew Winegarner Harish Lecamwasam Mark C. Kendall Shyamal Asher |
| author_facet | Andrew Winegarner Harish Lecamwasam Mark C. Kendall Shyamal Asher |
| author_sort | Andrew Winegarner |
| collection | DOAJ |
| description | Background. Traumatic airway injuries often require improvising solutions to altered anatomy under strict time constraints. We describe here the use of two endotracheal tubes simultaneously in the trachea to facilitate securing an airway which has been severely compromised by a self-inflicted wound to the trachea. Case Presentation: A 71-year-old male presented with a self-inflicted incision to his neck, cutting deep into the trachea itself. An endotracheal tube was emergently placed through the self-inflicted hole in the trachea in the ED. The patient was bleeding profusely, severely somnolent, and desaturating upon arrival to the operating room. Preservation of the tenuous airway was a priority while seeking to establish a more secure one. A video laryngoscope was used to gain a wide view of the posterior oropharynx and assist with oral intubation using a fiberoptic scope loaded with a second endotracheal tube. The initial tube’s cuff was deflated as the second tube was advanced over the fiberoptic scope, thereby securing the airway while a completion tracheostomy was performed. Conclusions. Direct penetrating airway trauma may necessitate early, albeit less secure, intubations though the neck wounds prior to operating room arrival. The conundrum is weighing the risk of losing a temporary airway while attempting to establish a more secure airway. Here, we demonstrate the versatility of common anesthesia tools such as a video laryngoscope and a fiberoptic bronchoscope and the welcome discovery of the trachea’s ability to accommodate two endotracheal tubes simultaneously so as to ensure a patent airway at all points throughout resuscitation. |
| format | Article |
| id | doaj-art-3f6ddac171b34137b2facead8c0dbbda |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-3f6ddac171b34137b2facead8c0dbbda2025-02-03T06:46:10ZengWileyCase Reports in Anesthesiology2090-63822090-63902021-01-01202110.1155/2021/99125539912553Two Endotracheal Tubes in One Trachea with a Traumatic InjuryAndrew Winegarner0Harish Lecamwasam1Mark C. Kendall2Shyamal Asher3Department of Anesthesiology, Rhode Island Hospital, Warren Alpert School of Medicine at Brown University, Providence, RI, USADepartment of Anesthesiology, Rhode Island Hospital, Warren Alpert School of Medicine at Brown University, Providence, RI, USADepartment of Anesthesiology, Rhode Island Hospital, Warren Alpert School of Medicine at Brown University, Providence, RI, USADepartment of Anesthesiology, Rhode Island Hospital, Warren Alpert School of Medicine at Brown University, Providence, RI, USABackground. Traumatic airway injuries often require improvising solutions to altered anatomy under strict time constraints. We describe here the use of two endotracheal tubes simultaneously in the trachea to facilitate securing an airway which has been severely compromised by a self-inflicted wound to the trachea. Case Presentation: A 71-year-old male presented with a self-inflicted incision to his neck, cutting deep into the trachea itself. An endotracheal tube was emergently placed through the self-inflicted hole in the trachea in the ED. The patient was bleeding profusely, severely somnolent, and desaturating upon arrival to the operating room. Preservation of the tenuous airway was a priority while seeking to establish a more secure one. A video laryngoscope was used to gain a wide view of the posterior oropharynx and assist with oral intubation using a fiberoptic scope loaded with a second endotracheal tube. The initial tube’s cuff was deflated as the second tube was advanced over the fiberoptic scope, thereby securing the airway while a completion tracheostomy was performed. Conclusions. Direct penetrating airway trauma may necessitate early, albeit less secure, intubations though the neck wounds prior to operating room arrival. The conundrum is weighing the risk of losing a temporary airway while attempting to establish a more secure airway. Here, we demonstrate the versatility of common anesthesia tools such as a video laryngoscope and a fiberoptic bronchoscope and the welcome discovery of the trachea’s ability to accommodate two endotracheal tubes simultaneously so as to ensure a patent airway at all points throughout resuscitation.http://dx.doi.org/10.1155/2021/9912553 |
| spellingShingle | Andrew Winegarner Harish Lecamwasam Mark C. Kendall Shyamal Asher Two Endotracheal Tubes in One Trachea with a Traumatic Injury Case Reports in Anesthesiology |
| title | Two Endotracheal Tubes in One Trachea with a Traumatic Injury |
| title_full | Two Endotracheal Tubes in One Trachea with a Traumatic Injury |
| title_fullStr | Two Endotracheal Tubes in One Trachea with a Traumatic Injury |
| title_full_unstemmed | Two Endotracheal Tubes in One Trachea with a Traumatic Injury |
| title_short | Two Endotracheal Tubes in One Trachea with a Traumatic Injury |
| title_sort | two endotracheal tubes in one trachea with a traumatic injury |
| url | http://dx.doi.org/10.1155/2021/9912553 |
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