Use of Airway Scope^® for Awake Intubation in the Lateral Position in a Patient with a Knife Wound

Abstract

We used an Airway Scope^®（AWS）to intubate a 79-year-old man with a back injury. The patient could not be placed in the supine position because a knife was stuck in his back approximately 20 cm toward the midline in the cranial direction. He was in hemorrhagic shock and was carried to the operating room with fluid resuscitation. Because of concern about the potential development of pneumothorax and cardiac tamponade, we administered low-dose fentanyl and ketamine and intubated the patient with the AWS while maintaining spontaneous breathing in the right lateral position. Upon completion of successful intubation, we started positive-pressure manually assisted ventilation and confirmed that his vital signs had not worsened. We then administered the anesthetics and started mechanical ventilation.

The patient left the hospital on foot on the 26th postoperative day. Intubation with the AWS in the lateral position was useful in this case of dorsal thoracic trauma.