• Viviane Chalhoub, Freda Richa, Issam El-Rassi, Christine Dagher, and Patricia Yazbeck.
• Saint Joseph University Medical School, Hotel-Dieu de France Hospital, Naccach Boulevard, Beirut, Lebanon.
• J Emerg Med. 2013 Jun 1;44(6):1097-100.

BackgroundIn trauma patients, particularly with head immobilization, tracheal intubation without the use of a stylet may be impossible.ObjectivesTo report a very rare but potentially fatal complication that may happen in any Emergency Department: fracture of the plastic sheath of an intubation stylet, reported only twice before in the literature.Case ReportTwo large plastic fragments detached from a stylet while intubating a trauma patient. One piece was removed from the endotracheal tube a few hours later in the operating room. The second fragment migrated asymptomatically into the pulmonary airway. It was successfully retrieved from the right bronchus 24 h later.ConclusionThis potentially life-threatening event may go unnoticed after intubation if the endotracheal tube is not obstructed by the fragment. Gentle withdrawal of the stylet from the tube is essential to avoid stylet fracture. Careful examination of the stylet after intubation may suggest a stylet fracture.Copyright © 2013 Elsevier Inc. All rights reserved.

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