title: Emergency percutaneous tracheostomy in a severely burned patient with upper airway obstruction and circulatory failure.
abstract: Airway inaccessibility is one of the most dreaded situations in emergency medicine. Surgical tracheostomy is not indicated in emergency situations because it takes a long time and can result in death if respiratory support cannot be provided during the procedure. Emergency percutaneous tracheostomy (PCT) was widely regarded as absolutely counterindicated. Recently, however, a number of studies have appeared on the safety and feasibility of PCT in situations regarded as presenting relative contraindications. We describe the life-saving action of Griggs' PCT in a patient with upper airway obstruction resulting from burns, smoke injuries, and unsuccessful tracheal intubation attempts. Emergency PCT using the Griggs technique was immediately performed without aseptic care, and a 9-mm internal diameter tracheostomy tube was successfully inserted in less than one minute. Griggs' PCT is a quick technique that secures an airway when tracheal intubation fails. The feasibility - in selected cases - of using an emergency Griggs' PCT, in experienced hands, rather than cricothyroidotomy or surgical tracheostomy, is recommended.
authors: Department of Critical Care.
authors: S
authors: S
authors: Kolias
authors: O
authors: O
authors: Castana
authors: M
authors: M
authors: Kyriakopoulou
authors: G
authors: G
authors: Rempelos
authors: G
authors: G
authors: Anagiotos
authors: D
authors: D
authors: Alexakis
authors: C
authors: C
authors: Roussos