Oral to nasal endotracheal tube exchange using tracheal tube guide and video laryngoscope in a pediatric patient with facial burns: a case report

Naoki Yogo; Taeko Sasaki; Masato Kozumi; Yuya Kinoshita; Yuichiro Muto; Katsuki Hirai; Yuichiro Yoshino

doi:10.1186/s12245-022-00451-3

Oral to nasal endotracheal tube exchange using tracheal tube guide and video laryngoscope in a pediatric patient with facial burns: a case report

Int J Emerg Med. 2022 Sep 5;15(1):42. doi: 10.1186/s12245-022-00451-3.

Authors

Naoki Yogo^{1

2}, Taeko Sasaki³, Masato Kozumi⁴, Yuya Kinoshita⁴, Yuichiro Muto^{4

5}, Katsuki Hirai^{4

5}, Yuichiro Yoshino⁶

Affiliations

¹ Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan. naoki.y0715@gmail.com.
² Division of Pediatric Emergency and Critical Care, Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto, 861-8520, Japan. naoki.y0715@gmail.com.
³ Department of Trauma Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
⁴ Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
⁵ Division of Pediatric Emergency and Critical Care, Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto, 861-8520, Japan.
⁶ Department of Dermatology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.

Abstract

Background: Airway management in children with severe burns is difficult because of airway edema and prolonged duration of ventilatory management. There is insufficient evidence to suggest that tracheostomy is beneficial for children.

Case presentation: A male child aged 1 year and 4 months was injured when he accidentally fell into a bathtub filled with boiling water. Furthermore, 85% of the burnt area, including the face and neck, consisted of second-degree burns; hence, oral tracheal intubation and resuscitative infusion were required. In this case, the patient was safely switched from oral to nasotracheal intubation using a tracheal tube guide and video laryngoscope, without the use of a bronchoscope, and ventilatory management could be continued for 2 weeks.

Conclusion: Oral to nasal endotracheal tube exchange using a tracheal tube guide and video laryngoscope may be useful not only for pediatric burn patients but also for adult patients who need to be safely switched from oral to nasotracheal intubation.

Keywords: Difficult airway; Intubation; Safe conversion; Tube exchanger.