Authors: Jonathan E. Martin¹; Rajesh Mehta²; Bizhan Aarabi²; James E. Ecklund¹; Amy H. Martin³; Geoffrey S. F. Ling¹

Source: Military Medicine, Volume 169, Number 6, June 2004 , pp. 496-497(2)

Publisher: AMSUS - Association of Military Surgeons of the U.S.

Abstract:

Intracranial insertion of a nasopharyngeal airway is an unusual and catastrophic complication of airway management in the patient with a severe closed head injury. We present an unfortunate 43-year-old patient with intracranial insertion of a nasopharyngeal airway during trauma resuscitation. The nasopharyngeal airway was removed. Attempts to resuscitate the patient were continued, but were eventually unsuccessful. Blind nasopharyngeal airway insertion may result in iatrogenic injury when used in the head-injured patient. Oropharyngeal airways may be used to assist with ventilation. However, it is preferable to definitively secure the airway through inline endotracheal intubation or with surgical techniques in this patient population. Should violation of the skull base occur, removal is accomplished in the controlled environment of the operating room.

Document Type: Research article

Affiliations: 1: National Capitol Consortium Neurosurgery, Walter Reed Army Medical Center, Washington, DC 20307. 2: Department of Neurological Surgery, University of Maryland Medical System, Baltimore, MD 21201. 3: Department of Radiology, Malcolm Grow Medical Center, Andrews Air Force Base, MD 20762.

Publication date: 2004-06-01

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• Military Medicine is the Association's official monthly journal. The objective of the Journal is to promote awareness of Federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to Federal healthcare. Its mission is: To increase healthcare education by providing scientific and other information to its readers; to facilitate communication; and to offer a prestige publication for members' writings.
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