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Published on May 10, 2011
This 30 year old patient having history of RTA, crashing car into a ditch was brought to ER. Initial investigations revealed Frontal Bone Fracture, Cervical Spine Subluxation at C3 and C4, Multiple Lacerations and Left Lower Limb Fractures. The patient was Hepatitis B positive too. He was shifted to Surgical ICU. He was unable to maintain his saturation above 85% with O2 mask so Intubation was planned to put him on ventilator. In view of his unstable cervical spine and cervical collar, the conventional manoeuvres of intubation i.e neck flexion and head extension were dangerous. That is why Flexible Fiberoptic Laryngoscopic Intubation was planned. In the end which is not shown in the video, this technique failed because of blood and copious mucous secretions blocking scope view. Then cervical collar was removed and Manual In-line Cervical Stabilization and Cricoid Pressure was applied and conventional Direct Laryngoscopic Intubation was performed successfully and patient put on ventilator (SIMV/Pressure Support Mode with Volume Control Ventilation; PEEP of 5.0 cm of H2O)