Rapid sequence tandem intubation to navigate a subglottic obstruction

Authors

Ravi V. Chacko, Advocate Aurora HealthFollow
Nisha X. Jain, University of Chicago, Department of Anesthesia and Critical Care, United States of America.
Brandon J. Baird, University of Chicago, Section of Otolaryngology, United States of America.
Alejandro A. Palma, University of Chicago, Section of Emergency Medicine, United States of America.

Recommended Citation

Chacko RV, Jain NX, Baird BJ, Palma AA. Rapid sequence tandem intubation to navigate a subglottic obstruction. Am J Emerg Med. 2023;67:196.e3-196.e5. doi:10.1016/j.ajem.2023.03.014

Affiliations

Advocate Christ Medical Center

Abstract

Emergency airway management requires matching the appropriate intubation tools to anticipated obstacles. Video laryngoscopy and flexible endoscopy are often used for difficult airways. Here we describe a case where neither method alone was anticipated to be sufficient. A 53-year-old female with an obstructing lung mass required intubation for a mixed type 1 and 2 respiratory failure. Chest x-ray revealed a tortuous subglottic obstruction. The patient could not be temporized on maximized non-invasive airway support. These factors made tandem intubation, sequentially using video laryngoscopy and flexible endoscopic intubation, an appropriate intubation strategy. In this case report we describe the rationale and technique for a rapid sequence tandem intubation.

Document Type

Article

PubMed ID

36964112