Articles: intubation.
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Turk J Anaesthesiol Reanim · Feb 2021
Case ReportsVideolaryngoscopy Bails us out of Difficult Intubation Scenarios in Syndromic Children: A Case Series.
Airway management in children with craniofacial anomalies can be complicated and may require multiple attempts with conventional direct laryngoscopy (DL). Videolaryngoscopes (VLs) have a well-established role in difficult airway management in adults; however, their role remains to be fully elucidated in paediatric age group. ⋯ Following initial failed attempts to intubate using DL, these children were subsequently intubated using VLs. Therefore, VLs should be used for initial intubation attempts in syndromic children with potential difficult airways.
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We present the case of an active duty 21-year-old male with severe hypoxic respiratory failure after accidentally ingesting, and subsequently aspirating, vaping liquid while intoxicated. Because of the increasing prevalence of vaping devices, this case highlights a unique risk of vape liquids with concentrated nicotine levels and appetizing labels and aromas. Vaping-associated pulmonary injury has been previously described in multiple publications, but unlike those patients with pathology after inhaling vaping products, our patient ingested and subsequently aspirated the highly nicotinic substance. ⋯ By treating preoxygenation as a procedure, the patient received adequate oxygenation resulting in successful intubation without harmful desaturation during the procedure. Given the prevalence of tobacco use in the military as well as the increasing popularity of vaping devices, future military providers have a responsibility to their patients to be prepared for similar case presentations. Fortunately, this case demonstrates that when managed properly, otherwise healthy patients without comorbidities often recover without significant long-term sequelae.