Airway management in a patient with penetrating thoracic spine injury / Sharmaine Casaol.

Includes appendices and bibliographical references.

Abstract: Airway management in trauma patients presenting with penetrating thoracic spine injury poses a major challenge to the anesthesiologist. Of critical importance in this case is the stabilisation of psineprior to and during airway manipulation, to prevent any further neural damage. Although awake fiberoptic intubation of the trachea is considered the gold standard for airway instrumentation in patients with posterior thoracic trauma, this technique requires the patients cooperation, special equipment, and extensive training, all of which might be difficult to accomplish in emergency situtation. This case report will discuss different options in securing the airway for patients with penetrating thoracic spine injury. Presented is a case of a 24 y/o female who underwent "E" wound Exploration and CTT insertion under general anesthesia after being rushed to the emergency room due to penetrating stab wound in the back. Due to the location of the injury, airway management poses a major challenge. With limited options, patient was positioned with her head placed on the foot part of the knife at the back was carefully placed in between the gap in the foot part of the table to be able to place the patient in a supine position prior to induction of general anesthesia. Anesthesia was maintained iwht oxygen, isoflurane, fentanyl and rocuronium. Intraoperative ventilation using a double lumen tube and surgery were uneventful. Extubation as well as the postoperative course was uneventful. Postoperative examination revealed no neurologica deficit. Patient was cared in postoperative ward with uneventful recovery and was later discharged.

Research - Department of Anesthesiology