Deadly suicidal attempt and burdensome airway management, challenges to anesthesiologist with exposed airway

Abstract

Rationale: Showcasing this case report is of essential importance to shed the light on this rare situation propelling advancement in clinical rationale to detect and manage such cases. Patient Concerns: A 25-year-old male patient presented with suicidal injury by cutting his throat open using a knife due psychiatric history of depression. Diagnosis: Clear-cut injuries to the neck area present with significant impairment to the human body functions from breathing to vascular injuries that eventually will lead to obstructed airways and haemorrhagic shock later. Interventions: In this case, we stress on the essentialness of the multidisciplinary team to manage and treat such critical situations, and this underlines the involvement of the anaesthesiologist to protect the airways in such difficult situations and immediately shifting the patient to the operation theatre involving the otolaryngologist, vascular surgeon and postoperatively by intensivists and psychiatrists. As the patient was arrested in the accident and emergency department, it was not applicable to take the patient to any imaging modality and this even created more challenge for the team to exclude any further injuries and to treat according to the standard acute care approach. Outcomes: Improved physical and psychiatric status which helped the patient to return to pre-injury state after fatal suicidal attempt. Lessons: Here, we highlight the urgency and the importance of immediate action in protecting the airways while following the ABCDE guidelines in addition to the rapid intervention, while minimizing time for imaging and shifting of the patient in such critical situations. Importance of the multidisciplinary team involvement while harmonizing treatment to avoid relapse and failure.