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A 54-Year-Old Woman With Postextubation StridorA Woman With Postextubation Stridor

Eugene Shostak, MD; Adnan Majid, MD, FCCP; Colleen Channick, MD
Author and Funding Information

From the Department of Interventional Pulmonology (Drs Shostak and Majid), Beth Israel Deaconess Medical Center; and Department of Interventional Pulmonology (Drs Shostak and Channick) and Special Procedures Unit (Dr Channick), Massachusetts General Hospital, Boston, MA

CORRESPONDENCE TO: Colleen Channick, MD, Special Procedures Unit, 55 Fruit St, Bigelow 952, Boston, MA 02114; e-mail: cchannick@mgh.harvard.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(5):e163-e166. doi:10.1378/chest.13-3077
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Extract

A 54-year-old woman developed a witnessed generalized tonic clonic seizure at work. Paramedics recorded a blood glucose level of 30 mg/dL. Despite normalizing the blood glucose level, the patient’s mental status did not improve, and she was intubated in the field. Given the limited view of the glottis, a tracheal tube introducer (Bougie) was used to facilitate intubation.

On arrival to the ED, the patient was awake and following simple commands. She was extubated but 1 h later developed somnolence and respiratory distress. After two unsuccessful attempts with direct laryngoscopy, she was reintubated using a videolaryngoscope with a size 7.0 endotracheal tube. During reintubation, there was difficulty obtaining adequate exposure of the glottis but no difficulty advancing the endotracheal tube through the vocal cords into the trachea.

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