Case Report

"Cannot Ventilate Cannot Intubate" scenario in a Five Years Old Girl

Abstract

Difficult airway is defined as situation that face mask ventilation, laryngoscopy, or intubation cannot be done by clinician as easy as he expects where it. Difficulties in children airway management do not occur frequently and aggressive airway management in children is not required often.
We present a case of “cannot ventilate, cannot intubate” scenario in a five years old girl with a supraglottic cyst in operating room. We started to sedate the patient with ketamine for awake intubation but the cyst obstructed the airway and we couldn’t ventilate her with mask. Two try of intubation with tube and bougie were failed and rigid bronchoscope could maintain the airway finally.

Apfelbaum JL, Hagberg CA, Caplan RA, Biltt CD, Connis RT, Nickinovich DG, et al. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2013; 118:251-270.

Murphy, MF, Walls, RM. Identification of the difficult and failed airway. In: Manual of emergency airway management, 2nd, Walls, RM (Eds), Lippincott Williams & Wilkins, Philadelphia 2004. p.74.

Sagarin MJ, Chiang V, Sakles JC, Barton ED, Wolfe RE, Vissers RJ, Walls RM. National Emergency Airway Registry (NEAR) investigators. Rapid sequence intubation for pediatric emergency airway management. Pediatr Emerg. Care. 2002; 18(6):417-23.

Pallin DJ, Dwyer RC, Walls RM, Brown CA 3rd; NEAR III Investigators. Techniques and Trends, Success Rates, and Adverse Events in Emergency Department Pediatric Intubations: A Report From the National Emergency Airway Registry. Ann Emerg Med. 2016; 67(5):610-615.

Luten, RC, Kisson, N. The difficult pediatric airway. In: Manual of Emergency Airway Management, 2nd, Walls, RM, Murphy, MF, Luten, RC, et al (Eds), Lippincott Williams & Wilkins, Philadelphia 2004. p.236.

Walker RW. Management of the difficult airway in children. J R Soc Med 2001; 94(7):341-4.

Lee A, Fan LT, Gin T, Karmakar MK, Ngan Kee WD. A systematic review (meta-analysis) of the accuracy of the Mallampati tests to predict the difficult airway. Anesth Analg 2006; 102(6):1867-78.

Murphy, MF. Sedation and anesthesia for awake intubation. In: Manual of Emergency Airway Management, 2nd, Walls, RM (Eds), Lippincott Williams & Wilkins, Philadelphia 2004. p.82

Blank RS, de Souza DG. Anesthetic management of patients with an anterior mediastinal mass: continuing professional development. Can J Anaesth. 2011; 58(9):853-9.

Jagannathan N, Sohn L, FiadjoeBJA G.E. Paediatric difficult airway management: what every anaesthetist should know. Br J Anaesth. 2016; 117 Suppl 1:i3-i5.

Files
IssueVol 4 No 1 (2018): Winter QRcode
SectionCase Report(s)
Keywords
difficult airway bronchoscopic intubation cannot ventilate cannot intubate

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Nazemian Yazdi N, Jafarieh A, Yusefi A. "Cannot Ventilate Cannot Intubate" scenario in a Five Years Old Girl. Arch Anesth & Crit Care. 2018;4(1):442-443.