Peri-Arrest airway obstruction

70 YOM choked while eating steak at home. Wife called 911 reporting partial obstruction. Dispatch advising patient turning blue and agonal respirations. On scene patient semi responsive, cyanosed, SP02% 77, HR 140, weak stridorous respirations. Two person BVM ventilations initiated. Patient given Midazolam to facilitate direct laryngoscopy with Miller 4 blade and magill forceps. Patient desaturates during each attempt at removal and requires BVM ventilations between attempts. 3 large pieces of steak removed. Smaller pieces located past vocal cords and unable to be removed. Difficult mask seal due to size. Mallampati 3, Cormack-Lehane Grade 3. Patient intubated with 8.0 ETT. SP02% improved to 95%, HR normalized, hypercapnic but improved during transport.

Diagnosis added by author

Airway Obstruction

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