Abstract
Airway management is critical during near-fatal obstruction of the upper airway in epiglottitis; however, this is challenging because of the sitting posture and agitated mental status of the patient. Moreover, there is currently no established protocol for safe airway management in patients with epiglottitis. Here, we describe the use of a conventional tracheal tube as a nasolaryngeal airway to maintain airway patency at the site of airway narrowing in the supine position, which enabled alleviation of imminent airway obstruction in a patient with epiglottitis. For definitive airway establishment, tracheostomy was then safely performed in the supine position.
Highlights
Acute epiglottitis is a cause of upper airway obstruction that can be fatal [1, 2]
Airway management was initiated in the awake state because anaesthesia induction was expected to cause complete airway obstruction
Airway management was initiated in the awake state because anaesthesia induction might have led to cause complete airway obstruction
Summary
Received July 2019; Revised 4 August 2019; Accepted August 2019; Published 31 October 2019. Airway management is critical during near-fatal obstruction of the upper airway in epiglottitis; this is challenging because of the sitting posture and agitated mental status of the patient. There is currently no established protocol for safe airway management in patients with epiglottitis. We describe the use of a conventional tracheal tube as a nasolaryngeal airway to maintain airway patency at the site of airway narrowing in the supine position, which enabled alleviation of imminent airway obstruction in a patient with epiglottitis. Tracheostomy was safely performed in the supine position
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