title: Inadvertent migration of guidewire into Murphy's eye of endotracheal tube during percutaneous dilatational tracheostomy.
abstract: Percutaneous dilatational tracheostomy is a commonly performed bedside procedure in the Intensive Care Unit. Although serious and fatal complications have been reported, the procedure is by and large safe to perform in experienced hands. We report here an innocuous problem encountered twice. After the guidewire insertion and dilatation, subsequent railroading became difficult owing to migration of guidewire into the Murphy's eye of the endotracheal tube (ETT). Awareness about this possibility can avert inadvertent delays and complications during the procedure. A tug or gentle pulling of ETT after insertion of the guidewire rules out an impaction in the eye or other part of the ETT.
authors.affiliation: Department of Anesthesiology and Critical Care, Tata Main Hospital, Jamshedpur, Jharkhand, India.
authors.forename: Binita
authors.initials: B
authors.lastname: Panigrahi
authors.affiliation: Department of Anesthesiology and Critical Care, Tata Main Hospital, Jamshedpur, Jharkhand, India.
authors.forename: Devi Prasad
authors.initials: DP
authors.lastname: Samaddar
authors.affiliation: Department of Anesthesiology and Critical Care, Tata Main Hospital, Jamshedpur, Jharkhand, India.
authors.forename: Tushar
authors.initials: T
authors.lastname: Kumar
keywords: Complications; guidewire; impaction; percutaneous tracheostomy