Abstract
Introduction: Securing the airway is the first and most important part in any trauma as per the Advanced Trauma Life Support (ATLS) guidelines, and an injury to the face and/or neck can lead to devastating results if the airway was not secured. Objective: A penetrating neck injury can be a life-threatening event if the airways were not secured. Case Report: 26 years old female patient was transferred to our Emergency Department (ED) from a rural secondary care facility, for a self inflicted, close range, GSW to the thyroid cartilage by a low velocity firearm. An attempt of oropharyngeal intubation was unsuccessful and as the patient’s saturation was dropping, the surgeon present in the rural ED elected to expand the entry wound and insert the tube directly through the trachea and transfer the patient to our tertiary care center. Conclusion: Securing the airways remains the most critical and challenging part even for the most skilled emergency physicians. At least a second and third alternatives should be prepared and ready in case of failure of intubation.
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