Citation

Vera Ching C, Gonzalez Londoño J, Carbó G, Ortiz P. BMJ Case Rep. 2020; 13(9).

Copyright

(Copyright © 2020, BMJ Publishing Group)

DOI

10.1136/bcr-2020-238895

PMID

32928817

Abstract

A 17-year-old patient suffered a motorcycle accident that lead to a direct trauma on the anterior cervical region. On arrival of the ambulance, the patient had laryngeal stridor and generalised hypoventilation but still managed to keep normal oxygen saturation (SpO2) levels. Patient was intubated on site and ventilated with lung protective ventilation (tidal volume of 6 mL/kg), positive end-expiratory pressure of 5 and a fraction of inspired oxygen of 100%, which allowed him to maintain SpO2 levels of 97%-98% throughout the ambulance transfer.

On arrival to the emergency department, his vital signs were stable, but he showed subcutaneous emphysema throughout the cervical, thoracic and abdominal region.

CT scan showed a disruption of the medial one-third of the trachea (17 mm from the jugular notch) of approximately 5 mm, with the orothracheal tube exiting the trachea through the disruption and locating itself anterior to the inferior portion of the trachea...

Language: en

Keywords

injuries; accidents; trauma; adult intensive care; otolaryngology / ENT; prehospital