MacGyvered Heliox Adapter During Awake Tracheostomy
A 79-year-old man with active COVID-19 infection superimposed on laryngeal cancer presented to the emergency room in acute respiratory distress with significant stridor. He previously declined offers for a tracheostomy. In the ED, 100% non-rebreather and heliox was applied prior to proceeding with an urgent awake tracheostomy in the OR. For optimal laminar flow, a facemask was applied throughout the case and heliox adapter was devised from spare materials in the anesthesia cart. He was maintained on a dexmedetomidine infusion. We discuss management strategies for an awake tracheostomy and illustrate an effective method for attaching heliox to the anesthesia circuit.
Al-Attar N, Skolnik B. MacGyvered heliox adapter during awake tracheostomy. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/5871