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. 2010 Jan;54(1):59-61.
doi: 10.4103/0019-5049.60501.

Management of difficult airway in penetrating cervical spine injury

Mukesh Kumar Prasad  1 , Ajay Kumar Sinha, Umesh Kumar Bhadani, Balbir Chabra, Kanchan Rani, Bhavana Srivastava
Affiliations

Management of difficult airway in penetrating cervical spine injury

Mukesh Kumar Prasad et al. Indian J Anaesth. 2010 Jan.

Abstract

Management of airway in trauma victim with penetrating cervical/thoracic spine injury has always been a challenge to the anaesthesiologist. Stabilisation of spine during airway manipulation, to prevent any further neural damage, is of obvious concern to the anaesthesiologist. Most anaesthesiologists are not exposed to direct laryngoscopy and intubation in lateral position during their training period. Tracheal intubation in the lateral position may be unavoidable in some circumstances. Difficult airway in an uncooperative patient compounds the problem to secure airway in lateral position. We present a 46-year-old alcoholic, hypertensive, morbidly obese person who suffered a sharp instrument (screwdriver) spinal injury with anticipated difficult intubation; the case was managed successfully.

Keywords: Difficult intubation; lateral position; malleable stylet; penetrating cervical spine injury.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Screwdriver protruding from back of neck of patient
Figure 2
Figure 2
X- Ray neck - Anterior-posterior and lateral views showing screwdriver at C7-T1 interspaces
Figure 3
Figure 3
Intubation accomplished in lateral position
See this image and copyright information in PMC

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