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

Abstract

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.