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VOLUME 14 , ISSUE 3 ( July, 2010 ) > List of Articles

CASE REPORT

Light at a tunnel′s end: The lightwand as a rapid tracheal location aid when encountering false passage during tracheostomy

Prabhu Manjunath, Daniel Anjilivelil, Sadasivan Iyer

Keywords : Decannulation, distorted anatomy, false passage, lightwand, open tracheostomy

Citation Information : Manjunath P, Anjilivelil D, Iyer S. Light at a tunnel′s end: The lightwand as a rapid tracheal location aid when encountering false passage during tracheostomy. Indian J Crit Care Med 2010; 14 (3):144-146.

DOI: 10.4103/0972-5229.74173

License: CC BY-ND 3.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2010; The Author(s).


Abstract

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.


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  1. Hung OR, Stewart RD. Lightwand Intubation: I. A new intubating device. Can J Anaesth 1995;42:820-5.
  2. Thomas JG. Airway Management. In: Miller RD, editor. Miller′s Anesthesia. 6th ed. Philadelphia: Elsevier; 2005. p. 1643-4.
  3. Addas BM, Howes WJ, Hung OR. Light-guided tracheal puncture for percutaneous tracheostomy. Can J Anaesth 2000;47:919-22.
  4. Agro F, Salvinelli F, Gherardi S, Casale M. The lightwand: A useful aid in the difficult tracheostomy. Can J Anesth 2002;49:1000-1.
  5. Young JS, Brady WJ, Kesser B, Mullins D. A novel method for replacement of the dislodged tracheostomy tube: The nasogastric tube “guidewire” technique. J Emerg Med 1996;14:205-8.
  6. Deutsh ES. Early tracheostomy tube change in children. Arch Otolaryngol Head Neck Surg 1998;124:1237-8.
  7. Windsor HM, Shanahan MX, Cherian K, Chang VP. Tracheal injury following prolonged intubation. Aust N Z J Surg 1976;46:18-25.
  8. Durbin CG. Early complications of tracheostomy. Respir Care 2005;50:511-5.
  9. Marelli D, Paul A, Manolidis S, Walsh G, Odim JN, Burdon TA, et al. Endoscopic guided percutaneous tracheostomy: Early results of a consecutive trial. J Trauma 1990;30:433-5.
  10. McGuire G, El-Beheiry H, Brown D. Loss of the airway during tracheostomy: Rescue oxygenation and re- establishment of the airway. Can J Anesth 2001;48:697-700.
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