Unusual case of guidewire traversing endotracheal tube cuff
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ABSTRACT :
Although the use of endotracheal tube for airway control during percutaneous dilatational tracheostomy provides better airway seal, it also carries the risk of damage to cuff from the needle. This report highlights a case where the guidewire entered the trachea after traversing the cuff without associated air leak. Use of a ‘tug test’ allowed detection of the cuff impalement by the guidewire.

CASE :

A 75 year old patient weighing around 70 kg was on mechanical ventilation for type 1 respiratory failure following pneumonia and unilateral hydro pneumothorax. PDT was planned to aid weaning. No difficulty was anticipated during pre-procedure assessment. After the pre-procedure preparation, checks, sedation and paralysis, the patient was placed in an extended neck position. The ETT was withdrawn under vision so that the cuff was positioned just below the cords.....

http://www.apicareonline.com/an-unusual-case-of-guidewire-traversing-endotracheal-tube-cuff-during-percutaneous-tracheostomy/
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