Right trace wrong place: a normal capnography trace despite the tip of the tracheal tube existing outside the airway

A Karmakar; M J Khan; N A H Shallik; A H M N Moustafa; Y M R A Toble; G F Strandvik

doi:10.1002/anr3.12313

Right trace wrong place: a normal capnography trace despite the tip of the tracheal tube existing outside the airway

Anaesth Rep. 2024 Jul 10;12(2):e12313. doi: 10.1002/anr3.12313. eCollection 2024 Jul-Dec.

Authors

A Karmakar¹, M J Khan¹, N A H Shallik^{1

2

3

4}, A H M N Moustafa⁵, Y M R A Toble¹, G F Strandvik^{2

3

6}

Affiliations

¹ Department of Anesthesiology, ICU and Perioperative Medicine Hamad Medical Corporation Doha Qatar.
² Department of Clinical Anesthesiology Weill Cornell Medicine - Qatar Doha Qatar.
³ Department of Clinical Anesthesiology, College of Medicine Qatar University Doha Qatar.
⁴ Anesthesia and Surgical Critical Care Department Tanta University Tanta Egypt.
⁵ Department of Diagnostic Radiology and Medical Imaging Hamad Medical Corporation Doha Qatar.
⁶ Department of Trauma Intensive Care Unit Hamad Medical Corporation Doha Qatar.

Abstract

Head and neck trauma can result in difficult airway management. A 25-year-old male required emergency tracheal intubation on arrival to the emergency department following a motorbike accident. Despite the presence of a normal capnography a computed tomography scan demonstrated a tracheal opening, an extra-tracheal position of the distal end of the tracheal tube, and extensive subcutaneous emphysema. The tube was re-directed into the trachea and the tracheal injury was surgically repaired. This case highlights that the presence of a normal capnograph does not necessarily mean that the distal end of the tracheal tube resides within the airway.

Keywords: airway management; capnography; tracheal injury; tracheal intubation.

Publication types

Case Reports