FAT NECKS - MODIFICATION OF A STANDARD SURGICAL AIRWAY PROTOCOL IN THE PREHOSPITAL ENVIRONMENT

We report two cases of trauma where a surgical airway was required. In both cases soft tissue swelling of the neck made modification of the Advanced Trauma Life Support (ATLS) airway guidelines necessary. A gum elastic bougie was used to guide a standard endotracheal tube into a cricothyroidotomy incision and secure the airway. Slight departure fro m standard techniques may be required in difficult circumstances to ac hieve a definitive airway. (C) 1997 Elsevier Science Ireland Ltd.