Use of a flexible intubating scope in combination with a channeled video laryngoscope for managing a difficult airway in the emergency department

Nicholas Sowers, George Kovacs

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Background Difficulty with intubation is not uncommon in the emergency setting. Video laryngoscopes (VLs) are commonly used to manage the difficult airway in the emergency department (ED). Intubation using a flexible bronchoscope, while considered the gold standard for managing the anticipated difficult airway in the operating room, is not commonly used in the ED. Case We present a case describing VL-assisted flexible scope intubation performed in the ED as a novel feasible approach to managing the difficult airway. A 65-year-old male, post cardiac arrest, with multiple unsuccessful attempts at prehospital intubation had rapid sequence intubation (RSI) performed and, despite obtaining a view with a King Vision™ VL, the skilled operator was unable to advance the endotracheal tube (ETT). An Ambu™ aScope3 flexible intubating scope (FIS) was placed through the ETT loaded in the channel of the King Vision and advanced through the cords to a position proximal to the carina. The ETT was then advanced easily over the FIS and down the trachea. Why Should an Emergency Physician Be Aware of This? Although video laryngoscopy is commonly used in the ED, intubation can prove difficult, despite having an adequate view of the glottis. Use of an FIS, however, through a channeled VL makes navigation of the ETT easier and facilitates tube advancement, which can be difficult with VL. Channeled VL-assisted use of an FIS is a viable option for managing the difficult airway.

Original languageEnglish
Pages (from-to)315-319
Number of pages5
JournalJournal of Emergency Medicine
Volume50
Issue number2
DOIs
Publication statusPublished - Feb 1 2016

Bibliographical note

Publisher Copyright:
Copyright © 2016 Elsevier Inc. Printed in the USA. All rights reserved.

ASJC Scopus Subject Areas

  • Emergency Medicine

PubMed: MeSH publication types

  • Case Reports
  • Journal Article

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