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Case Reports
Navigating Goals of Care While Confronting an Urgent, Difficult Intubation: A Case Report.
- Christine Choi, Paul S Pagel, and Stephen R Estimé.
- From the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
- A A Pract. 2019 Mar 15; 12 (6): 193-195.
AbstractUrgent airway management is challenging because time constraints limit thorough evaluation and planning before endotracheal intubation. In this report, we describe a case in which an airway history review revealed extraordinarily complex airway anatomy that led to a decision not to attempt intubation in a man with end-stage chronic obstructive pulmonary disease. We emphasize the utility of reviewing history and imaging before attempted urgent intubation. We discuss the importance of a multidisciplinary approach that includes the patient, their family, and consultants when high-risk intubation is contemplated. The ethical role of the anesthesiologist is also discussed.
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