Local Anesthetic and Handholding Help Keep Patient Breathing

Steven Dale Boggs, MD Anesthesiologist, Bronxville, NY

I had just walked into my office when the ER called to tell me that they had a patient who took a medication that was making his wind pipe close. I immediately gathered all my equipment to do a fiberoptic intubation, a procedure that allows us to put a breathing tube in without surgery.

I told them to take him to the operating room and I immediately called the OR nurses and alerted them to have the room ready in case we needed to do a tracheostomy – a surgical procedure to cut a hole in his throat. I also called a throat surgeon to be available for backup if necessary.

When I got to the OR it was not a good situation. The patient was an elderly veteran who was morbidly obese. I couldn’t give him any sedation because he might stop breathing. But I also was worried about him becoming more anxious so I asked the nurse to hold his hand to reassure him.

I put some numbing medication in the back of his throat and was able to place the breathing tube down into his lungs and keep him breathing. The nurse held his hand throughout the procedure.

After we got the breathing tube in, we transferred him to the intensive care unit where they continued his care and treatment. We were prepared to do surgery if necessary but it would have been much harder on the patient and it would have required a longer hospital stay. Because of what we were able to do, he had the tube removed in a few days and returned home.