LeHeR, a simple novel approach for difficult airway in non-trauma patients

Managing the difficult airway presents a great challenge to anaesthesiologists and emergency physicians. Although there are many methods and scoring systems available to predict and anticipate difficult airway, the dictum in emergency airway is to always expect the unexpected. We have encountered a...

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Bibliographic Details
Published in:BMJ case reports 2019-08, Vol.12 (8), p.e230201
Main Authors: Yezid, Nur Hafiza, Poh, Khadijah, Md Noor, Julina, Arshad, Afifi
Format: Article
Language:English
Subjects:
Adult
Airway management
Airway Management - methods
Anesthesia
Anesthesiology
Case reports
Child, Preschool
Emergency medical care
Fatal Outcome
Female
Hospitals
Humans
Infant
Intubation
Intubation, Intratracheal - adverse effects
Intubation, Intratracheal - methods
Laryngoscopy - methods
Male
Novel Treatment (New Drug/Intervention
Established Drug/Procedure in New Situation)
Patient Positioning - methods
Patients
Pediatrics
Ultrasonic imaging
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Summary:Managing the difficult airway presents a great challenge to anaesthesiologists and emergency physicians. Although there are many methods and scoring systems available to predict and anticipate difficult airway, the dictum in emergency airway is to always expect the unexpected. We have encountered a novel simple method of improving laryngoscopic view in difficult airway. We report four cases of difficult airway encountered in our district hospital from November 2017 to December 2018, in which intubation was performed using a simple manoeuvre called supine left head rotation (LeHeR). In all these cases, LeHeR manoeuvre has proven to be successful after more than a single attempt at intubation using various methods. The manoeuvre improves drastically the laryngoscopic view of Cormack-Lehane from 3B and 4 to 1 and 2.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2019-230201