MacGyvered Heliox Adapter During Awake Tracheostomy

Document Type

Conference Proceeding - Restricted Access

Publication Date



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.


American Society of Anesthesiology Annual Meeting, San Diego, CA, October 8-12, 2021.