My Difficult Airway

Looks can be deceiving. I was not supposed to have a difficult airway, but we found out the hard way that wasn’t true. I was about to undergo an exploratory laparotomy for suspected appendicitis in 1989, and my wife was adamant that an attending anesthesiologist perform my intubation. The anesthesiology resident at a large Midwest teaching hospital made a claim that I suspect many of us did as we advanced through training and began to feel procedurally invincible. He claimed that the attending anesthesiologist rarely did intubations, and that the residents who performed them daily were more prepared. Unaware of any unique issues with my airway and wanting to be a good patient, I didn’t attempt to override the resident. I woke up from anesthesia with a swollen, bleeding, and extremely painful pharynx, and my right central incisor was abraded and roughened. We learned that the resident made four attempts before the attending took over and successfully placed the airway. The soft tissue injury to the pharynx resolved with time, and my dentist filed the tooth smooth again. Subsequent surgeries, however, included a successful bougie intubation and a not-so-pleasant awake intubation. This May, my shoulder pain reached a point where I knew it was time for surgery again. My left rotator cuff muscle needed to be repaired, just like the right one had years before. Intubation methods were a necessary topic of conversation with my anesthesiologist again. My “3-3-2” airway assessm...
Source: M2E Too! Mellick's Multimedia EduBlog - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs