|
RF 1,
I am going to look and ask about the retrograde kits. I am not certain if we have the kits in the OR or ED but I know we have used it or something like it in the past. I will add it to my arsenal for "next time" by having the OR nurses order them if we do not. Resistance does change to the 4th power and I should have gone larger.
ADAL, I have used the Cook kit before at another institutions on adults. It is a good kit to have around but not sure if we have them where I am. I know we have used the wires out of a triple lumen kit before to go retrograde. As I recall we passed a tube exchanger over the wire once we nicked the skin with a scapel and grabbed it in the mouth with a McGill foriceps and then were able to intubate over the tube exchanger.
Doczilla, the thyroid, as you know, loves to bleed, so anything to stay away is helpful as blood in the field is the enemy especially in these tight cases!
I took our craniofacial plastic surgery specialist to see the child today. He thinks it is a hamartoma. We could see hair and skin and what looks like a hemangioma on the lateral side of the mass (that is what was probably bleeding as it had a clot on it). He said that once the child stabilizes they will get some CT's or MRI's. Looking at it on PE, he thinks that he will have to split the mandible to get it all out.
The child is on vasopressors and has pulmonary hypertension today on the oscillatory vent. Also found out the child had other genetic issues (imperforate anus). So, this may all be for not. Time will tell.
Anyway, great discussion.
Thanks,
D-
|