Inadvertent migration of guidewire into Murphy′s eye of endotracheal tube during percutaneous dilatational tracheostomy

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Tushar Kumar
2. Devi Prasad Samaddar
ISSN
0972-5229
DOI
10.4103/0972-5229.178186
Volume
20
Issue
3
Publishing Year
2016
Pages
3
Author Affiliations
    1. Department of Anesthesiology and Critical Care, Tata Main Hospital, Jamshedpur, Jharkhand, India
    1. Department of Anesthesiology and Critical Care, Tata Main Hospital, Jamshedpur, Jharkhand, India
  • Article keywords
    Complications, guidewire, impaction, percutaneous tracheostomy

    Abstract

    Percutaneous dilatational tracheostomy is a commonly performed bedside procedure in the Intensive Care Unit. Although serious and fatal complications have been reported, the procedure is by and large safe to perform in experienced hands. We report here an innocuous problem encountered twice. After the guidewire insertion and dilatation, subsequent railroading became difficult owing to migration of guidewire into the Murphy′s eye of the endotracheal tube (ETT). Awareness about this possibility can avert inadvertent delays and complications during the procedure. A tug or gentle pulling of ETT after insertion of the guidewire rules out an impaction in the eye or other part of the ETT.

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