Tuesday, April 14, 2015

A Novel Technique Of Anesthesia Induction In Supine Position With Impaled Knife In The Back

Case History:

A 35years old male presented with a knife in the back (Figure 1). Computerized tomography of chest was performed in prone position (Figure2), which revealed knife inside the right chest with partial collapse of lung and right hemopneumothorax.

POINTS TO PONDER:
Putting patient in supine position by simple and reproducible method by authors has distinct advantages:

  • After the patient was put on supine position, the anesthesia induction procedure can be routine.
  • In supine position rapid sequence induction can be done more effectively.
  • Even though authors have not used lung isolation, bronchial blockers in case of torrential bleeding can rapidly institute it.
  • Insertion of central venous lines and in case required arterial line could be inserted rapidly.
  • In case of need of resuscitation during induction, can be given effectively.
  • Table height should not be varied once fixed at the level of the trolley.
  • Team effort is the key to success.

Conclusion:

This kind of out of the box thinking is life saving in emergency challenging clinical scenarios.

Read Full Article at:  http://www.annals.in/article.asp?issn=0971-9784;year=2015;volume=18;issue=2;spage=231;epage=233;aulast=Kumar

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