• Anaesth Intensive Care · Nov 2012

    Case Reports

    Failed intubation and failed oxygenation in a child.

    • A S Santoro, M G Cooper, and A Cheng.
    • Department of Anaesthesia, Children's Hospital at Westmead, Sydney, New South Wales, Australia. andrea.santoro@health.nsw.gov.au
    • Anaesth Intensive Care. 2012 Nov 1;40(6):1056-8.

    AbstractA 'can't intubate, can't oxygenate' scenario in a child is fortunately extremely rare. We report a case of this life-threatening event in a four-year-old boy suffering from a rare genetic disorder, fibrodysplasia ossificans progressiva. He presented for manipulation of his dislocated jaw and was identified preoperatively as having a difficult airway. Despite extensive preparation, a catastrophic loss of airway control occurred minutes after induction of general anaesthesia, necessitating a life saving emergency tracheostomy. This report highlights the small evidence base and lack of definitive algorithms relating to how best to rescue a paediatric 'can't intubate, can't oxygenate' situation. Paediatric anatomical factors dictate that immediate procession to a tracheal surgical airway may be the optimal management.

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