Prehospital Laryngeal Tube Airway Device Placement Resulting in Hypopharyngeal Perforation: A Case Report. Prehosp Emerg Care 2020;24(4):590-594
Date
09/25/2019Pubmed ID
31550188DOI
10.1080/10903127.2019.1671565Scopus ID
2-s2.0-85074336793 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
A 26-year-old female patient presented in cardiac arrest from presumed opioid overdose. An Ambu King LTS-D laryngeal device was placed by EMS providers for airway management during the resuscitation. There was no documented difficulty with placement and breath sounds and waveform capnography were consistent with appropriate placement. The resuscitation was terminated on scene after extensive resuscitative efforts by the EMS crew. Upon autopsy of the patient, it was discovered that the laryngeal tube device had caused a deep 5 cm perforation to the left piriform recess. The laryngeal tube had bent and was pushed into the perforation in the piriform recess; had the patient had regain of spontaneous circulation this could have caused significant morbidity. Laryngeal tube airway devices have shown increased usage in healthcare settings, in particular in the prehospital arena. Studies of these airway devices have shown they have quick insertion times, high success rates, and low complications. Tongue swelling and minor trauma are common complications of laryngeal tube airway devices. The case report describes a rare, yet potentially life-threatening, complication of laryngeal tube airway device placement- hypopharyngeal injury. If unrecognized, this injury could lead to serious complications. Providers should be aware of the common and uncommon injuries that are associated with prehospital laryngeal tube airway device placement.
Author List
Chinn M, Biedrzycki LAuthor
Matthew Chinn MD Associate Professor in the Emergency Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAirway Management
Capnography
Emergency Medical Services
Fatal Outcome
Female
Heart Arrest
Humans
Hypopharynx
Iatrogenic Disease
Intubation, Intratracheal
Laryngeal Masks
