Intubation of a pediatric patient in prone position: an anesthetic challenge

ABSTRACT

This is a case of M.L., a five year old boy from Cavite who accidentally slipped and fell into an open canal with a protruding steel bar which pierced his back. No other injuries were sustained. The steel bar was cut shorter with a saw and the patient as brought to a local hospital with the object still impaled on his right paravertebral area. Initial physical examination findings revealed a conscious patient with a rusty steel bar impaled on T12- L1, with tenderness and bleeding on the site. Chest, lung and abdominal findings were essentially normal. Rectal examination revealed tight sphincter tone and rectal vault was not collapsed. Neurological examination showed Glasgow Coma Scale score of 15; motor function of upper extremities was 5/5, lower extremities 0/5. He was given tetanus toxoid and venocylis was started. The patient was the referred to Philippine General Hospital five hours post- injury and was subsequently admitted.