title: Failed intubation and failed oxygenation in a child.
abstract: A 'can't intubate, can't oxygenate' scenario in a child is fortunately extremely rare. We report a case of this life-threatening event in a four-year-old boy suffering from a rare genetic disorder, fibrodysplasia ossificans progressiva. He presented for manipulation of his dislocated jaw and was identified preoperatively as having a difficult airway. Despite extensive preparation, a catastrophic loss of airway control occurred minutes after induction of general anaesthesia, necessitating a life saving emergency tracheostomy. This report highlights the small evidence base and lack of definitive algorithms relating to how best to rescue a paediatric 'can't intubate, can't oxygenate' situation. Paediatric anatomical factors dictate that immediate procession to a tracheal surgical airway may be the optimal management.
authors.affiliation: Department of Anaesthesia, Children's Hospital at Westmead, Sydney, New South Wales, Australia. andrea.santoro@health.nsw.gov.au
authors.forename: A S
authors.initials: AS
authors.lastname: Santoro
authors.forename: M G
authors.initials: MG
authors.lastname: Cooper
authors.forename: A
authors.initials: A
authors.lastname: Cheng
mesh_terms: D000768:Anesthesia, General / Q000379:methods; D002675:Child, Preschool; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007568:Jaw / Q000473:pathology; D004204:Joint Dislocations; D008297:Male; D009221:Myositis Ossificans / Q000150:complications*; D056948:Orthognathic Surgical Procedures; D010100:Oxygen / Q000008:administration & dosage*; D014139:Tracheostomy / Q000379:methods*
chemical_list: D010100:Oxygen