Challenging airway in a paediatric patient impaled by a freezer pop stick.

Park EJ, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-220620 Description As experts of the human airway, it is our job as anaesthesiologists to control and secure the airway in the safest way possible for the patient. The perioperative anaesthetic plan always includes an airway component, ranging from bag-mask ventilation to endotracheal intubation. Routine surgical procedures may warrant a certain standardised airway strategy that may vary among institutions. However, there exist situations that are less common, in which standard airway practice is unclear. If the injury is suspected to be in a highly sensitive area and securing an airway may compromise or cause further injury, radiographic imaging may be warranted. Figure 1 depicts a paediatric patient impaled in the soft palate of the left oropharynx by a freezer pop stick that the patient had been previously enjoying and accidentally fell onto. (left of image). The CT scan portion of the figure is a contrast CT scan of the head and neck, in which the tract of the freezer pop stick is visualised. The most notable aspect is that the proximal (to the patient) end of the freezer pop stick lies only 2 mm anterior to the