PerOral Endoscopic Myotomy Failed intubation | Final Exam Viva

Send us Fan MailCheck our the full viva in the Final Exam Coursehttps://anaesthesia.thinkific.com/courses/FinalExamYou are the duty anaesthetist at a busy tertiary hospital. Your provisional fellow calls you forurgent assistance with an airway emergency.They have performed a rapid sequence induction and attempted to intubate a 22-year-old manfor a Per-Oral Endoscopic Myotomy (POEM) procedure for type 2 achalasia in the maintheatres.Intubation was attempted with a videolaryngoscope and hyperangulated blade. The percentageof glottic opening visible was 10% and they were unable to pass the endotracheal tube or agum elastic bougie. They were then unable to bag-mask ventilate the patient but successfullyplaced a second generation supraglottic airway. Ventilation has been restored, and greentinged fluid has been noted in the gastric port.Current observations are:HR 95 bpmBP 97/56 mmHgSpO2 90% on FiO2 1.0ETCO2 41 mmHg (5.47 kPa)TV 400 mL with a small air leakWeight 169 kgHeight 199 cmBMI 42 kg/m2Past Medical HistoryType 2 achalasiaClass III obesityAttention deficit hyperactivity disorderMild developmental delaySevere anxietyMedicationLisdexamfetamine 70 mg once dailyMelatonin 4 mg nocteDiazepam 10 mg was given orally preoperativelyAllergiesNil knownWhat are your priorities in managing this situation?---------Find us atInstagram: https://www.instagram.com/abcsofanaesthesia/Twitter: https://twitter.com/abcsofaWebsite: http://www.anaesthesiacollective.comPodcast: ABCs of AnaesthesiaPrimary Exam Podcast: Anaesthesia Coffee BreakFacebook Page: https://www.facebook.com/ABCsofAnaesthesiaFacebook Private Group: https://www.facebook.com/groups/2082807131964430---------Check out all of our online courses and zoom teaching sessions here!https://anaesthesia.thinkific.com/collectionshttps://www.anaesthesiacollective.com/courses/---------#Anesthesiology #Anesthesia #Anaesthetics #Anaesthetists #Residency #MedicalSchool #FOAMed #Nurse #Medical #Meded ---------Any questions please email [email protected]: The information contained in this video/audio/graphic is for medical practitioner education only. It is not and will not be relevant for the general public.Where applicable patients have given written informed consent to the use of their images in video/photography and aware that it will be published online and visible by medical practitioners and the general public.This contains general information about medical conditions and treatments. The information is not advice and should not be treated as such. The medical information is provided “as is” without any representations or warranties, express or implied. The presenter makes no representations or warranties in relation to the medical information on this video. You must not rely on the information as an alternative to assessing and managing your patient with your treating team and consultant. You should seek your own advice from your medical practitioner in relation to any of the topics discussed in this episode’ Medical information can change rapidly, and the author/s make all reasonable attempts to provide accurate information at the time of filming. There is no guarantee that the information will be accurate at the time of viewingThe information provided is within the scope of a specialist anaesthetist (FANZCA) working in Australia.The information presented here does not represent the views of any hospital or ANZCA.These videos are solely for training and education of medical practitioners, and are not an advertisement. They were not sponsored and offer no discounts, gifts or other inducements.