INTRODUCTION Difficult intubation remains a key problem and the value of the gum elastic bougie as a first approach is well recognised. MATERIALS AND METHODS A fine fibre-optic endoscope (Rapiscope, Cook Critical Care) was used in 50 patients to verify placement of a custom-designed hollow plastic bougie prior to "rail-roading" a tracheal tube. Following induction and muscle relaxation, direc...

INTRODUCTION Patients with severe pulmonary hemorrhage due to unilateral trauma or a bleeding cancer often present to the emergency department in acute respiratory distress. Although it is generally recommended to perform single lung intubation, most emergency department providers do not have access to or are not familiar with double-lumen endotracheal tubes, and blind insertion of an endotrach...

191 Surgical cricothyroidotomy is considered a critical skill in emergency airway management, though it is rarely used and fraught with complications. A variety of approaches are taught, including both the standard and rapid four-step techniques. We report a case in which an air medical crew used a gum-elastic bougie (endotracheal tube introducer), a common device in many airway kits, to facili...

We report the successful use of the Airtraq as a rescue device following failed direct laryngoscopy, in patients deemed at increased risk for difficult tracheal intubation. In a series of seven patients, repeated attempts at direct laryngoscopy with the Macintosh blade, and the use of manoeuvres to aid intubation, such as the gum elastic bougie placement, were unsuccessful. In contrast, with th...

Involvement of cervical spine in ankylosing spondylitis limits neck movement resulting in difficult intubation. We report a case of 45-yr-old lady of ankylosing spondylitis with restricted neck movement planned for emergency laparotomy. Grade 3 Cormack and Lehane laryngoscopic view was observed with Macintosh laryngoscope and gum elastic bougie could not be negotiated. At second attempt with Mc...

External distraction using a rigid external distractor (RED) frame (RED frame II, KLS-Martin, Jacksonville, USA) is frequently used for maxillary distraction and reconstruction.[1-3] Airway management with the RED frame could be a greater risk of failed intubation/extubation. It could significantly interfere with ventilation with a face mask or intubation by direct laryngoscopy. However, anaest...