Airway management of penetrating neck injury by large foreign body impalement: Report of a case

Prichayudh, Supparerk; Pak‐art, Rattaplee; Sriussadaporn, Suvit; Sriussadaporn, Sukanya; Kritayakirana, Kritaya; Tharavej, Chadin; Tingthanathikul, Wipada; Suansawan, Channarong; Tsunoyama, Taichiro; Capin, Allan; Capin, Yesenia

doi:10.1016/j.injury.2009.10.025

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…The long, semi-sharp surfboard fin caused both an extensive crushing upper airway lesion and a sharp vascular laceration. The former, involving the left tongue root and right palatine tonsil, was similar to impalement injuries by other semi-sharp objects, such as a tree branch [ 11 ], pieces of metal [ 12 ], and wire [ 13 ]. Repeated ETI attempts may cause complete airway obstruction, with a devastating outcome.…”

Section: Discussionmentioning

confidence: 99%

“Cannot ventilate, cannot intubate” situation after penetration of the tongue root through to the epipharynx by a surfboard: a case report

et al. 2017

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BackgroundSurfing is an increasingly popular activity and surfing-related injuries have increased accordingly. However, to the best of our knowledge, there are no reports of penetrating upper airway injuries in surfers. We present a “cannot ventilate, cannot intubate” situation following penetrating neck injury by a surfboard fin.Case presentationA previously healthy 29-year-old Japanese man was swept off his board by a large wave and his left mandible, tongue root, and right epipharynx were penetrated by the surfboard fin. He presented with severe hypovolemic shock because of copious bleeding from his mouth. Direct laryngoscopy failed, as did manual ventilation, because of the exacerbated upper airway bleeding and distorted upper airway anatomy. Open cricothyrotomy was immediately performed, followed by surgical exploration, which revealed extensive ablation of his tongue root and laceration of his lingual artery. After definitive hemostasis and intensive care, he returned home with no sequelae.ConclusionsThe long, semi-sharp surfboard fin created both extensive crushing upper airway lesions and a sharp vascular injury, resulting in a difficult airway. This case illustrates that surfing injuries can prompt a life-threatening airway emergency and serves as a caution for both surfers and health care professionals.

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Section: Discussionmentioning

confidence: 99%

“Cannot ventilate, cannot intubate” situation after penetration of the tongue root through to the epipharynx by a surfboard: a case report

et al. 2017

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“…Very few cases described in the literature have successful outcomes, and none of these cases include airway management and intubation at the scene by EMS personnel. [2][3][4][5][6] Prehospital care is a crucial component to the successful outcomes of trauma patients, and standard trauma protocols should be followed at all times for any patient with an impalement injury. The initial priority of EMS should be ensuring rapid freeing of the patient from suspension by qualified personnel.…”

Section: Discussionmentioning

confidence: 99%

Field Airway Management of a Construction Worker with an Impaling Rebar Injury to the Neck and Brain

Nicolaisen

Ahmed

Hancock

et al. 2012

Prehospital Emergency Care

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This article discusses a case of airway management by air ambulance emergency medical services (EMS) providers in a 22-year-old man impaled through the neck into the brain with 0.5-inch rebar. Penetrating neck injuries (PNIs) with impalement are extraordinarily rare. It is important for EMS providers and emergency medicine physicians to have an understanding of the initial management of an impaled patient with PNI, including having an organized approach to establishing a definitive airway and recognizing the airway complications that PNI may cause. This article discusses out-of-hospital management of impaled patients.

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“…This technique depends on availability of a fiberscope, the cooperation of the patient [47,55] and the skills of the operator. Another confounding factor to this method of securing the airway is that any foreign bodies or blood will hinder the use of the fiberscope [47] although in skilled hands it has proved very effective [17-20, 23,24,40].…”

Section: Fiberoptic Intubationmentioning

confidence: 99%

Creating Airway Management Guidelines for Casualties with Penetrating Airway Injuries

et al. 2010

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Anaesthetists in the Defence Medical Services (DMS) are currently dealing with casualties who have an increased prevalence of injuries due to blast, fragmentation and gunshot wounds. Despite guidelines already existing for unanticipated difficult tracheal intubation these have been designed for a civilian population and might not be relevant for the anticipated difficult airway experienced in the deployed field hospital. In order to establish an overview of current practice, three methods of investigation were undertaken; a literature review, a survey of DMS Anaesthetists and a search of the UK Joint Theatre Trauma Database. Results are discussed in terms of anatomical site, bleeding in the airway, facial distortion, patient positioning and an anaesthetic approach. There are certain key principles that should be considered in all cases and these are considered. Potential pitfalls are discussed and our initial proposed guidelines for use in the deployed field hospital are presented.

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Airway management of penetrating neck injury by large foreign body impalement: Report of a case

Cited by 3 publications

References 9 publications

“Cannot ventilate, cannot intubate” situation after penetration of the tongue root through to the epipharynx by a surfboard: a case report

“Cannot ventilate, cannot intubate” situation after penetration of the tongue root through to the epipharynx by a surfboard: a case report

Field Airway Management of a Construction Worker with an Impaling Rebar Injury to the Neck and Brain

Creating Airway Management Guidelines for Casualties with Penetrating Airway Injuries

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