Light at a tunnel's end: The lightwand as a rapid tracheal location aid when encountering false passage during tracheostomy

Goneppanavar, Umesh; Rao, Shwethapriya; Shetty, Nanda; Manjunath, Prabhu; Anjilivelil, Daniel Thomas; Iyer, Sadasivan S.
July 2010
Indian Journal of Critical Care Medicine;Jul-Sep2010, Vol. 14 Issue 3, p144
Academic Journal
False passage and loss of airway during tracheostomy are not uncommon, especially in patients with short and thick necks. Distorted neck anatomy following either repeated insertion attempts or due to underlying malignancy may make it very difficult to locate the trachea even while attempting open/surgical tracheostomy, despite good exposure of the neck in such situations. The lightwand is not an ideal device for tracheal intubation in such patients. However, it can be useful in these patients while performing open tracheostomy. Passing the lightwand through the orotracheal tube can aid in rapid identification of the trachea in such situations and may help reduce the occurrence of complications subsequent to repeated false passage. We report a series of four such cases where use of lightwand aided in rapidly locating the trachea during tracheostomy complicated by distorted anatomy.


Related Articles

  • Treating tracheo-innominate artery fistula with interposition of a pectoralis major myocutaneous flap. Roh, Jong-Lyel; Na, Myung-Hoon; Kim, Kwang // European Archives of Oto-Rhino-Laryngology;Feb2006, Vol. 263 Issue 2, p180 

    Tracheo-innominate artery fistula (TIF) is an uncommon life-threatening complication of tracheostomy. A prompt diagnosis and surgical intervention can save the life of a TIF patient. Several methods of reconstructing the tracheal defect have been reported, but may not be available in the...

  • Tracheocutaneous fistula as a complication of laryngotracheal separation surgery. Zocratto, Orlando; Zocratto, Keli; Mao, Ana; Oliveira, Geovane; Ferreira, Luiza // European Archives of Oto-Rhino-Laryngology;Aug2012, Vol. 269 Issue 8, p1973 

    To evaluate the relationship between the occurrence of tracheocutaneous fistula of the proximal tracheal stump regarding the indication (therapeutic or prophylactic) of laryngotracheal separation surgery (LTS) and regarding the presence of a current or previous tracheostomy when LTS was...

  • Rotational Collapse of Trachea after Percutaneous Dilatational Tracheostomy. Mahmoodpoor, Ata; Karvandian, Kasra // Oman Medical Journal;Jan2010, Vol. 25 Issue 1, p1 

    The article offers information on the medical case of a trachea rotational collapse of a 26-year-old female after a Percutaneous Dilatational Tracheostomy (PDT). The patient was brought to the Intensive Care Unit (ICU) because of a relapse of Myastenia Gravis (MG), wherein a PDT was conducted....

  • Changing patterns of airway accidents in intubated ICU patients. Kapadia, F. N.; Bajan, K. B.; Singh, S.; Mathew, B.; Nath, A.; Wadkar, S. // Intensive Care Medicine;Jan2001, Vol. 27 Issue 1, p296 

    Objective: To document the changes in patterns of airway accidents in intubated patients.Design: Prospective recording of all airway accidents over two periods: 1994-1997 and 1998-1999.Patients: Ventilated patients (5,046) intubated for 9,289 days over 4...

  • Customized Tracheostomy Cannula as a Therapeutic Adjunct in Tracheal Stenosis. Doh Young Lee; Jungirl Seok; Wonjae Cha; Won Yong Lee; J. Hun. Hah; Tack-Kyun Kwon; Kwang Hyun Kim; Myung-Whun Sung // Case Reports in Otolaryngology;2013, p1 

    Tracheotomy is often successfully used to manage tracheal stenosis, as a temporizing measure prior to definitive treatment or a long-term remedy. In some patients, where a sizeable portion trachea is stenotic, the fixed arm of an ordinary tracheotomy tube may not be of sufficient length to...

  • Percutaneous tracheostomy: A cost-effective alternative to... McHenry, Christopher R.; Raeburn, Christopher D. // American Surgeon;Jul1997, Vol. 63 Issue 7, p646 

    Focuses on percutaneous tracheostomy as the cost-effective alternative to standard open tracheostomy. Methodology of the study; Indications for tracheostomy; Cost analysis for patients who underwent percutaneous versus open tracheostomy; Complication rates for percutaneous tracheostomy.

  • Percutaneous Dilatational Tracheostomy Is as Safe as Open Tracheostomy. Khalili, Theodore M.; Koss, Wega; Margulies, Daniel R.; Morrison, Esther; Shabot, M. Michael // American Surgeon;Jan2002, Vol. 68 Issue 1, p92 

    Although percutaneous dilatational tracheostomy (PDT) has been advocated as an alternative to open tracheostomy (OT) its relative safety has been questioned repeatedly. This study prospectively compared the safety and complications of PDT and OT. Ninety-four patients underwent PDT and 252...

  • Bedside tracheostomy: A STEP by STEP GUIDE. Astle, Sonia M.; Caulfield, Eileen V. // RN;Oct2003, Vol. 66 Issue 10, p41 

    Discusses a step-by-step guide to bedside tracheostomy. Definition of percutaneous tracheostomy; Supplies and equipment; Preparation of the patients.

  • Usefulness and Safety of Open Tracheostomy by Paramedian Approach for Cervical Infection: Esophageal and Tracheal Injury and Necrotizing Fascitis. MORIWAKI, YOSHIHIRO; SUGIYAMA, MITSUGI; IWASHITA, MASAYUKI; HARUNARI, NOBUYUKI; TOYODA, HIROSHI; KOSUGE, TAKAYUKI; ARATA, SHINJU; SUZUKI, NORIYUKI // American Surgeon;Nov2010, Vol. 76 Issue 11, p1251 

    Tracheostomy is hardly performed in patients with cervical infection close to the site of the tracheostomy. This study aimed to present and clarify the usefulness and safety of open tracheostomy performed by the paramedian approach technique. The procedure is as follows. A 2.5-cm paramedian...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics