Unanticipated Difficult Airway Management in a Trauma Partient with Severe Ankylosing Spondylitis

Ankylosing Spondylitis is a debilitating chronic arthropathy that affects multiple joints. Anaesthesiologists face significant challenges when dealing with the airway implications of this disease, especially when it is unanticipated that a difficult airway may be encountered. This case describes a 42-year-old trauma victim who required an emergency denitive trachea at his ward. Ankylosing Spondylitis and complex airway anatomy led to his intubation failure. He was eventually given an emergency surgical tracheostomy. The successful management of a difficult airway was possible thanks to the appropriate use of modern airway adjuncts as well as workplace soft skills.

UNANTICIPATED DIFFICULT AIRWAY MANAGEMENT IN A TRAUMA PATIENT WITH SEVERE ANKYLOSING SPONDYLITIS

Ankylosing spondylitis is a chronic debilitating arthropathy affecting multiple joints in the body. Airway implications related to the disease pose a signicant challenge to the anaesthesiologists especially when an unanticipated difcult airway is encountered. A case of 42 year old trauma victim who needed an emergency denitive airway at ward set up, is reported here. Failed intubation due to complex airway anatomy associated with ankylosing spondylitis ensued him being ended up with an emergency surgical tracheostomy. Appropriate use of newer airway adjuncts and workplace soft skills contributed to successful management of an unanticipated difcult airway.

Airway Trauma: Assessment and Management

Recognizing airway trauma and safety management is challenging for any anaesthesiologist. Many types of airway injuries require identifying airway anatomy correctly; early assessment and proper management are crucial for saving many lives. Proper management involves the classification of those patients into three categories. Each one has a unique and different control. Knowing your capabilities and skills are very important for safe airway management. It does not matter where you are but skills, knowledge of airway management algorithms and tools you have. After reading this book chapter, the participant will be able to define airway trauma, proper airway risk assessment and safety management.

Chronic cough in children

A chronic cough in children is defined in the British Thoracic Society guidelines as a cough of 8 weeks or more. The aetiology of a chronic cough in children differs from adult populations, due to decreased cough reflex control in children, differences in airway anatomy and physiology, and immunological and neurological maturation changes. The three most common causes of chronic cough in adults (asthma, gastro-oesophageal reflux, and upper airway cough syndrome) account for less than 10% of the causes in children. Thus, it is important to assess and manage chronic cough in children differently.