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Failed tracheostomy under local anaesthesia…plan B?

Published online by Cambridge University Press:  02 June 2006

B Maiya  and
H L Smith
B Maiya
Affiliation:
Department of Anaesthesia, Cambridge University Hospitals, Cambridge, UK
H L Smith
Affiliation:
Department of Anaesthesia, Cambridge University Hospitals, Cambridge, UK
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Abstract

Severe stridor of recent onset is a challenge to deal with because of the lack of investigations on which to base the management plan. We describe a case of an elderly lady who presented to us with a short history of severe stridor. We encountered unanticipated difficulties with tracheostomy under local anaesthesia as the thyroid was replaced by a diffuse mass and the airway had to be secured by an awake fibre-optic intubation. Awake fibre-optic intubation is thought to be a relative contraindication in acute upper airway obstruction, but occasionally tracheostomy under local anaesthesia may not be possible and in experienced hands an awake fibre-optic intubation is a reasonable alternative.

Keywords

Airway ObstructionTracheostomyIntubationIntratracheal
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 120 , Issue 10 , October 2006 , pp. 882 - 884
Copyright
2006 JLO (1984) Limited

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