Use of the Cook® Staged extubation set for reintubation following complications of major head and neck surgery

Use of the Cook® Staged extubation set for reintubation following complications of major head and neck surgery

Published: 17 Aug 2017

© Anaesthesia Cases / 2017-0171 / ISSN 2396-8397

Authors

Dr Helen Goddard [1]
Dr Anna Hutton [2]
  • [1] Consultant, Department of Anaesthesia, Critical Care and Pain Management, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, United Kingdom
  • [2] Senior Clinical Fellow, Anaesthesia Department , Great Ormond Street Hospital for Children Foundation Trust, London, United Kingdom

Summary

Head and neck surgery frequently presents anaesthetists with challenging airways but re-intubation for postoperative complications further increases this level of difficulty. The use of airway exchange catheters (AEC) for “at risk” extubations are recommended by the Difficult Airway Society (DAS) in their 2011 extubation guidelines [1]. This is against the advice of the manufacturer of the Cook® AEC which does not recommend its use beyond immediate exchange of tracheal tubes [2]. The Cook® Staged Extubation Set (SES) is designed specifically for this task but no case reports have been published describing its use for tracheal re-intubation. We describe two techniques for the use of the SES for emergency re-intubation following complications after head and neck reconstruction with a free flap.

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