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Case 10: Changing a Nasotracheal Tube for an Oral Tube in the Intensive Care Unit

  • John G. Brock-Utne
Chapter

Abstract

A 10-year-old boy, otherwise healthy, is admitted to the trauma center after a motor vehicle accident. He has suffered a fracture of the second cervical vertebrae without neurologic deficit. The fracture is managed with the application of a halo-fixator, and he is observed in the intensive care unit (ICU). Twenty-four hours later, he develops respiratory distress and pulmonary congestion. An electrocardiogram (ECG) reveals moderate aortic valve regurgitation, probably as a result of the blunt chest trauma. A decision is made to treat the pulmonary edema with tracheal intubation and intermittent positive pressure ventilator. The halo-fixator makes direct laryngoscopy impossible. A nasal endotracheal intubation is undertaken using the fiber-optic bronchoscope, without incident.

Keywords

Pulmonary Edema Tracheal Intubation Trauma Center Cervical Vertebra Motor Vehicle Accident 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Reference

  1. 1.
    Hambly PR, Field JM. An unusual case for reintubation. Anaesthesia. 1995;50:568.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • John G. Brock-Utne
    • 1
  1. 1.Department of AnesthesiaStanford UniversityStanfordUSA

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