Nasal intubation of a difficult airway following supraglottic airway rescue facilitated by video laryngoscopy and a flexible intubation scope

Abstract

The management of a patient following airway rescue with a supraglottic airway (SGA) is debatable. This report describes a case of successful orotracheal intubation via a SGA used for airway rescue after a “Can’t Intubate, Can Ventilate” (non-emergency) airway scenario. Surgery required nasotracheal intubation so the second part of the case report describes the exchange of an orotracheal tube to a nasotracheal tube with a proved difficult laryngoscopy. The technique required three anaesthetists, two flexible intubation scopes, a videolaryngoscope and the Aintree intubation catheter (AIC). The case illustrates the technique of securing the required type of tracheal tube to facilitate surgery as an alternative to waking up the patient and postponing surgery.