Tracheal injury as a sequence of multiple attempts of endotracheal intubation in the course of a preclinical cardiopulmonary resuscitation

Management of the difficult airway requires an appropriate approach based o n personal clinical experiences. For every physician involved in rescue and emergency medicine, it is important to know the difficult airway algorithm and be familiar with alternative techniques of managing the difficult airw ay. We report a case of tracheal injury caused by multiple attempts at intu bating the trachea. Based on current knowledge, apart from surgical equipme nt for cricothyroidotomy the laryngeal mask airway (LMA) and the Combitube (ETC) should be available on any ambulance vehicle staffed by an emergency physician. In future, blind intubation through the intubating laryngeal mas k airway (ILMA) could offer a new opportunity. (C) 1999 Elsevier Science Ir eland Ltd. All rights reserved.