• Fumihiro Ohchi, Nobuyasu Komasawa, Noriko Kadono, and Toshiaki Minami.
• Masui. 2015 Jan 1;64(1):92-4.

AbstractWe report a case of impossible ventilation in a patient with severe nasal bleeding. A 47-year-old man with intractable nasal bleeding was scheduled for emergent hemostasis under general anesthesia. He also had alcohol-related cirrhosis and was highly obese (165 cm, 93 kg). Although he sufficiently fasted and did not experience nausea in the supine position, we planned crash intubation in the head-elevated position with the Pentax-AWS Airwayscope (AWS) in order to avoid vomiting after induction of anesthesia. After fentanyl, propofol, and rocuronium administration, the patient vomited a large amount of blood, which led to a deterioration of SpO2. Mask ventilatidn was impossible even after oral suctioning. We intubated the trachea with the Macintosh laryngoscope and suctioned blood from the trachea; SpO2 gradually improved and the trachea was washed with a large amount of normal saline. The patient was transferred to the intensive care unit and extubated uneventfully on day 3 postoperatively.

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