An 18 year-old man has been in ICU for 7 days after jumping from a building. A tracheostomy was performed yesterday. He has now developed acute respiratory distress and you are unable to pass a suction catheter through the tracheostomy tube.
This chest X-ray was taken a few hours prior to the onset of his respiratory distress.
Trauma Tribulation #001
Questions
There is a tracheostomy tube in appropriate position and a central line in appropriate position. There is a tooth in the right main bronchus which on review of chest X-rays taken in the previous week had been there every day!
The immediate intervention required is removal of the tracheostomy tube – the inability to pass a suction catheter indicates that the tracheostomy tube is blocked.
This the tracheostomy tube and the tooth:
About Paul Young
'In the Fast Lane': Pulmonary Puzzle #003 http://su.pr/72uUGc and Trauma Tribulation #001 http://su.pr/7Cnxzi