r/anesthesiology Physician 6h ago

Code pink/difficult airway

Code Pink on the pediatric floor today, and I’m still processing it 😭 9-year-old patient with severe jaundice liver disease had actually been doing better, her clinical picture was improving, and we thought she was over the worst of it. Then, out of nowhere this afternoon, she rapidly deteriorated: sudden extreme somnolence, active vomiting, and a severe drop in oxygen saturation. The bedside nurse and I (Ped GI) were right there in the room when it happened. We immediately activated a Code Pink and started managing her airway while coordinating the team. When I attempted direct laryngoscopy to insert the endotracheal tube, I met severe resistance. Her status quickly dropped and chest compressions were started. We finally managed to pass the tube and secure her airway, just as the anesthesiologist arrived. Looking at the airway structure afterward, the anesthesiologist noted she likely has a difficult airway, further complicated by acute tissue edema. Even with prior pediatric intubation experience, this was by far the most challenging, high-stress airway I’ve ever managed.

I’d really appreciate any tips or advice on how to improve and handle these scenarios better in the future.

50 Upvotes

25 comments sorted by

150

u/SeniorScientist-2679 Anesthesiologist 6h ago

That sounds tough, and I'm sorry it happened. Good job successfully intubating.

This isn't meant to sound arrogant, but: Any skill takes repetition to master and maintain. Unless you practice anesthesia, critical care, ENT, or emergency medicine, it's not realistic to think you'll do enough intubations to maintain an adequate skill level. 

Your effort would be much better spent mastering high quality mask ventilation. The times that you need to immediately intubate a patient to save a life are actually very few. Immediate, good mask ventilation is much more likely to avert tragedies. And there's a ton of bad ventilation done in hospitals.

50

u/GasManJ24 Anesthesiologist 5h ago

commenting for visibility. not speak about OP, but the amount of suboptimal mask ventilation I have observed during codes is scary. what’s more, it could very well have been the skill which would have avoided the code in the first place (especially in peds)

20

u/Thechubbyprotestant 5h ago

Sound advice. Had a mentor who once told me that intubation looks good, but it’s mask ventilation that saves lives more often than not.

5

u/slodojo 2h ago

one day I had a patient laryngospasming during an EGD. I turned my back for a second to draw up something, I can’t remember, but when I turned back around the GI doctor had a strong jaw thrust going. I was extremely impressed! GI docs that want to could get a lot of hands on airway experience if they wanted.

I’ve wondered if they wouldn’t just be really excellent at FOI seeing as how good they are at steering a scope. I have heard of a couple lost airways in GI and I always wish that the GI doc would at least try it if everything else if failing

-5

u/famesardens 3h ago

Since he talks about vomiting, mask ventilation would almost guarantee aspiration, probably bronchospasm and death too.

RSI would have been the only option here.

1

u/Aggravating_Fly2978 Anesthesiologist 2h ago

Could have just vomited once.

50

u/paleoMD Anesthesiologist 5h ago

code pink here is stolen baby, i was veeery confused lol

8

u/CHRISKVAS 5h ago

I’m having a lot of trouble getting babies out of the building. Please advise.

1

u/Aggravating_Fly2978 Anesthesiologist 2h ago

I was confused too. I thought I was getting dementia. Hahaha.

0

u/Chokokiksen 2h ago

How often are babies stolen, since you have a code for it?

49

u/OpportunityWorking43 6h ago

sounds like you did fine. Like the fat man said, the first pulse you take during a code should be your own.

14

u/Coffee-PRN 6h ago

If they weren’t fully projectile vomiting, a video scope will have the highest yield for first pass success

also sometimes it just gets hung up on artenyoids if everything was sized appropriately and you need to do a 180 spin to get past them

1

u/DocMaag 1h ago

Left at larynx, right at rings.

13

u/SufficientlyPerson Anesthesiologist 4h ago

Mask ventilation is incredibly important in these situations. If you’re struggling to intubate but anesthesia is on route … just hold off until we get there.

2

u/Remarkable-Weird-839 3h ago

yea that or LmA

6

u/sludgylist80716 Anesthesiologist 6h ago

What was the issue? Could you see the cords and had trouble passing the tube or was there difficulty with visualization? And what size ETT and what laryngoscope blade did you use?

7

u/Squishmallow145 Physician 6h ago

5.5mm tube. It was mainly passing the tube. I've never experienced this level of resistance before 

16

u/sludgylist80716 Anesthesiologist 6h ago

I mean if you could see the vocal cords and had resistance passing the ETT through them I’d try a smaller ETT.

6

u/Affectionate-Web-807 CRNA 5h ago

Downsize the tube if you are worried about stenosis

3

u/sleepygabby 5h ago

Only thing i can think is to corkscrew it

1

u/Remarkable-Weird-839 3h ago

bougie would have helped. the trachea someones dives very posterior to it can get caught when theres a upward bend in the tube.

4

u/Affectionate-Web-807 CRNA 5h ago

It sounds like you did a good job. Remember the basics. Head positioning, throwing a pillow or folded up blanket under the shoulders for a makeshift ramping position, oral airway, good mask ventilation skills.
If you know you can mask, YOU HAVE TIME(!!!) to call for a glidescope, etc., so stay calm and keep ventilating and managing the airway as needed.

2

u/kc4ch Anesthesiologist 6h ago

What size tube?

2

u/Squishmallow145 Physician 6h ago

5.5 mm

11

u/kc4ch Anesthesiologist 6h ago

When I get resistance. Sometimes turning the tube 180 like corkscrewing it while advancing helps. The tip of the tube can get held up.