Case 89: Watch Out

Abstract

Today you are working with a very keen medical student. Your patient is a 6-year-old male scheduled for a knee arthroscopy (25 kg, 4′11″, ASA 1). Your anesthetic plan is to use an LMA and have the patient breath spontaneously. He is anesthetized with propofol and is easy to ventilate without a Guedel-styled airway. You ask the medical student to attempt to ventilate the patient, but he is not able to do so satisfactorily. You take over and you have mores success. Thinking that the student will be able to ventilate better with a Guedel-styled airway, you ask him to open a number 2 Guedel airway from its plastic cover (Portex Ltd., Ashford, UK). He rips the cover off and you ask him to insert the airway. Unfortunately, despite the fact that the airway looks correctly placed, the student still cannot ventilate the child. You take over, but you cannot ventilate the child either. You remove the airway and find that it is now easy to ventilate the child.