Open AccessLight at a tunnel′s end: The lightwand as a rapid tracheal location aid when encountering false passage during tracheostomy
Author(s) -
Goneppanavar Umesh,
Shwethapriya Rao,
Smiti Nanda,
Manjunath Prabhu,
Daniel Thomas Anjilivelil,
Sadasivan S Iyer
Publication year - 2010
Publication title -
indian journal of critical care medicine/indian journal of critical care medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 30
eISSN - 1998-359X
pISSN - 0972-5229
DOI - 10.4103/0972-5229.74173
Subject(s) - medicine , airway , intubation , surgery , malignancy , cricoid cartilage , transillumination , tracheal intubation , bronchoscopy , anesthesia , larynx , pathology
False passage and loss of airway during tracheostomy are not uncommon, especially in patients with short and thick necks. Distorted neck anatomy following either repeated insertion attempts or due to underlying malignancy may make it very difficult to locate the trachea even while attempting open/surgical tracheostomy, despite good exposure of the neck in such situations. The lightwand is not an ideal device for tracheal intubation in such patients. However, it can be useful in these patients while performing open tracheostomy. Passing the lightwand through the orotracheal tube can aid in rapid identification of the trachea in such situations and may help reduce the occurrence of complications subsequent to repeated false passage. We report a series of four such cases where use of lightwand aided in rapidly locating the trachea during tracheostomy complicated by distorted anatomy.