TY - CHAP M1 - Book, Section TI - An Uncooperative Patient with a History of a Difficult Intubation Requiring Tracheal Intubation in the Emergency Department A1 - Mayer, Katherine A1 - Mosier, Jarrod A2 - Hung, Orlando R. A2 - Murphy, Michael F. Y1 - 2024 N1 - T2 - Hung’s Management of the Difficult and Failed Airway, 4th Edition AB - Police and paramedics are called to a busy intersection where a 28-year-old male was seen running through traffic and was presumeed to have been hit by a car. He was tackled by police and physically restrained until Emergency Medical Services (EMS) arrived and injected his thigh with 5 mg of intramuscular midazolam. Police left the scene, and the patient arrives at the emergency department by EMS 10 minutes after the midazolam injection. He is still agitated and uncooperative. The security staff place him in four-point restraints, and he is still combative. EMS has no identification on the patient, and he is not able to provide you with his past medical history. His heart rate is in the 140s and regular. He will not lie still enough to get a blood pressure measurement. The patient is screaming incomprehensible words mixed with profanities, with a faint inspiratory stridor as he gasps between fits. Peripheral pulses are strong and regular, skin is diaphoretic but warm, and you notice what appears to be a well-healed tracheostomy scar. You also notice a small laceration with underlying hematoma on the forehead. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/09/12 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1202476732 ER -