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A difficult airway made worse by apprehension: an obese young male with COVID 19


Intubation of a critically ill patient in the emergency department is always considered a
difficult airway. Timing, patient factors which are not optimized, and intubation done by
infrequent intubators. Add to this the complications and demands of Covid 19 pandemic
which make crash intubations a thing feared for personal safety as well as successful
completion of intubation without complications. If the patient has intrinsic comorbid
conditions contributing to a difficult airway, worse the procedure would be. Furthermore,
Covid pneumonia presents its own challenges in preoxygenation, timing of the intubation,
ventilation of the patient and transport as well. This is a patient I came across during the
third wave of covid19 pandemic in Sri Lanka, working in the Emergency department night
shift. He came in acute respiratory distress and required intubation and ventilation.


diabetes, hypertension, lymphadenopathy, neck mobility, facial deformities, invasive ventilation, adequate metabolic compensation, respiratory compensation