Prone Position Airway Management of a Child following Penetrating Trauma to the Back

Abstract

Traumatic penetrating injuries to the back are uncommon in children. This type of injury presents many considerations for airway management to the anesthesiologist, including having to secure the airway in a prone position. Although there have been several reports about intubation in the prone position for adult patients in emergency conditions, such studies on pediatric patients are rare. We present the case of a male child with an impaled steel shaft connected to a toy car wheel in his lower back, requiring an emergent operation under general anesthesia. Due to resource limitations, the patient was intubated using an adult-sized video laryngoscope in the prone position. The patient remained stable during the operation and was discharged without complications. A postoperative discussion was held later to review the case and gain insights from the rest of the anesthesiology team. Prone intubation in pediatric patients can be safely accomplished using various techniques, depending on the urgency of the need, the availability of resources, and the knowledge and skills of the provider. The authors hope that their colleagues can learn from sharing this experience.