気道緊急に対して輪状甲状靱帯切開を行い救命した1例

A ６０ year-old male was brought to our emergency department by ambulance due to sudden onset of dyspnea. On examination, he was in coma since his level of consciousness decreased during transport, blood pressure was １９９／１１１mmHg, heart rate was１００ beats per minute, respirations were １０ per minute, blood oxygen saturation level（SpO２）was１００％ via assisted ventilation with Bag-Valve-Mask, and stridor was heard on auscultation. Those findings indicated airway emergency and endotracheal intubation was required. However, attempts at intubation were unsuccessful due to restriction of mouth opening. Muscle relaxant was then given to perform rapid sequence intubation, which caused vomiting. Failure to ventilation and intubation resulted in cardiopulmonary arrest. Chest compression was started immediately and decision for cricothyrotomy was made. １０ minute after cricothyrotomy, he revived. Subsequently, systemic management including therapeutic normothermia was performed at intensive care unit, then he regained consciousness. He was discharged １ month after admission.