A retropharyngeal-mediastinal hematoma with supraglottic and tracheal obstruction: The role of multidisciplinary airway management

• Main Authors: Birkholz Torsten, Kröber Stefanie, Knorr Christian, Schiele Albert, Bumm Klaus, Schmidt Joachim
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2010-01-01
• Series: Journal of Emergencies, Trauma and Shock
• Subjects: Airway obstruction; endotracheal; emergency medicine; intubation; tracheostomy; trauma center
• Online Access: http://www.onlinejets.org/article.asp?issn=0974-2700;year=2010;volume=3;issue=4;spage=409;epage=411;aulast=Birkholz

A 77-year-old man suffered hypoxemic cardiac arrest by supraglottic and tracheal airway obstruction in the emergency department. A previously unknown cervical fracture had caused a traumatic retropharyngeal-mediastinal hematoma. A lifesaving surgical emergency tracheostomy succeeded. Supraglottic and tracheal obstruction by a retropharyngeal-mediastinal hematoma with successful resuscitation via emergency tracheostomy after hypoxemic cardiac arrest has never been reported in a context of trauma. This clinically demanding case outlines the need for multidisciplinary airway management systems with continuous training and well-implemented guidelines. Only multidisciplinary staff preparedness and readily available equipments for the unanticipated difficult airway solved the catastrophic clinical situation.