Inadequate management of a difficult airway. Case SENSAR of the trimester

Revista española de anestesiología y reanimación
Sistema Español de Notificación en Seguridad en Anestesia y Reanimación (SENSAR)

Abstract

A clinical case reported to SENSAR is presented (www.sensar.org). A patient came to the operating room for surgery for parathyroidectomy. She had several predictors of difficult airway management, including a story of difficulties in previous intubations in other hospitals, as the patient reported. Therefore, after evaluation in preoperative consultation, fibreoptic bronchoscopy intubation was recommended. The day of surgery after induction of general anesthesia direct laryngoscopy was performed, without recognizing any glottic structure (Cormack-Lehane grade iv). Conventional laryngoscope was changed to a videolaryngoscope (Airtraq(®)) to try to improve the laryngoscopic view, but there were difficulties with handling and insertion of it, causing minor injuries to the lingual mucosa. Finally, tracheal intubation was achieved after several attempts. Analysis of the incident revealed the active error due to lack of experience of the professional who performed intubation maneuvers, favored by latent factors or contributors as were the complex pathology of the patient and the absence of protocols to difficult airway management in the hospital. Communication and analysis of this incident served to highlight the importance of the se...Continue Reading

References

Jul 24, 2010·Korean journal of anesthesiology·Sang-Jin ParkDeok Hee Lee
Feb 1, 2013·Anesthesiology·Jeffrey L ApfelbaumUNKNOWN American Society of Anesthesiologists Task Force on Management of the Difficult Airway
Apr 11, 2013·Anaesthesiology Intensive Therapy·Magdalena Łasińska-KowaraMariusz Łapiński

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