RT Book, Section
A1 Sakles, John C.
A1 Murphy, Michael F.
A2 Hung, Orlando R.
A2 Murphy, Michael F.
SR Print(0)
ID 1146617442
T1 Airway Management in the Emergency Department
T2 Hung's Difficult and Failed Airway Management, 3e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259640544
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1146617442
RD 2024/04/19
AB A  21-year-old  man  is  brought  to  the  emergency  department  (ED)  after  sustaining  a  close  range  shot  gun  blast  to  the  face  and  neck.  He  appears  intoxicated  and  has  an  altered  mental  status.  He  intermittently  becomes  very  agitated  and  combative.  He  is  unable  to  give  a  coherent  history.  His  vital  signs  are  as  follows:  BP  160/10,  HR  120,  RR  26,  temperature  37.8°C.  Room  air  oxygen  saturation  is  97%.  There  are  numerous  pellet  wounds  to  the  left  side  of  the  face  and  neck  with  tissue  loss  and  active  bleeding.  There  is  a  small  hematoma  on  the  left  side  of  the  neck  and  subcutaneous  air  can  be  palpated  in  the  region.  The  larynx  can  be  palpated  and  appears  to  be  slightly  off  the  midline.  When  he  speaks,  his  words  appeared  slurred.  It  is  difficult  to  ascertain  whether  his  voice  is  hoarse,  but  there  is  no  overt  stridor.  The  lungs  are  clear  bilaterally  with  equal  breath  sounds.  The  patient  is  in  need  of  immediate  airway  control.