Awake Fiberoptic Argumentative Essay

A 29-year-old, 150 kg, 157 cm female presented for an incision and drainage of the right foot due to cellulitis. She had a past medical history of obstructive sleep apnea, asthma, super obesity, and acute kidney injury. She denied any smoking and illicit drug use history. She denied taking any home medications. Inpatient medications included piperacillin and tazobactam 3.375G every 6 hours, pantoprazole, heparin subcutaneous, and normal saline 100ml/hr. Significant lab values included BUN 44 mg/dl, creatinine 1.5mg/dl, glucose 198mg/dl, and WBC 12 K/ul. Upon physical examination, the patient appeared lethargic, arousable to stimulation, able to state name and date of birth. The patient was rated an ASA 4. Airway examination showed Mallampati IV, a thyromental distance of two fingerbreadths, and able to extend her neck. Mallampati, thyromental distance, and super obesity indicated potential difficult airway. Difficult airway cart, Glidescope …show more content…
Keeping the patient spontaneous breathing is the main principle of an awake fiberoptic intubation. The sitting position has shown to aid fiberoptic intubations. Fiberoptic intubation is not without flaws. Since the patient is awake, they become uncooperative. The patient presented, in this case, was uncooperative. Suctioning her oral pharynx was used to test her gag reflex. She did not exhibit a gag during the test. Anesthesia professionals attempted to place an oral airway however it was unsuccessful due to patient resisting it. Therefore, a nasal intubation was implemented. The patient did have increased bleeding after the trachea was intubated nasally. Trauma and bleeding can cause increased risk of