Document Detail


Crisis resource management of the airway in a patient with Klippel-Feil syndrome, congenital deafness, and aortic dissection.
MedLine Citation:
PMID:  19299791     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Klippel-Feil syndrome is a visually arresting deformity wherein severe restriction of cervical motion predicts a difficult airway. Even minor distraction of the neck risks cervical spine or neurologic injury, so regional techniques, awake fiberoptic intubation, or awake tracheostomy are recommended anesthetic approaches. We present a case of aortic dissection in a Klippel-Feil syndrome patient for whom congenital bilateral deafness, coupled with the urgency of the surgery, mitigated against the recommended first-choice techniques. Using anesthesia crisis resource management methods, a multi-member team rehearsed predefined roles and then managed the airway via inhaled induction of anesthesia, followed by flexible fiberoptic intubation.
Authors:
Omar M Khawaja; J Taylor Reed; Shahzad Shaefi; Hovig V Chitilian; Warren S Sandberg
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  108     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-20     Completed Date:  2009-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1220-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia and Critical Care, Massachusetts General Hospital, and Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Algorithms
Anesthesia, General* / psychology
Aneurysm, Dissecting / complications,  surgery*
Anxiety / etiology,  prevention & control
Aortic Aneurysm / complications,  surgery*
Blood Pressure
Bronchoscopes
Bronchoscopy*
Cervical Vertebrae / abnormalities
Deafness / complications*,  congenital
Humans
Intubation, Intratracheal / instrumentation,  methods*,  psychology
Klippel-Feil Syndrome / complications*,  pathology
Laryngoscopes
Laryngoscopy*
Male
Monitoring, Intraoperative
Optical Fibers
Patient Care Planning
Patient Care Team
Treatment Outcome
Vascular Surgical Procedures* / psychology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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