Management of a traumatic tracheal tear: a case report

This case report describes a posterior tracheal tear in a healthy 8-year-old girl. The child sustained the injury while riding her scooter, when the handlebars of the scooter dislodged after running into the curb, causing the shaft to strike her in the manubrium of the sternum. The child presented with subcutaneous emphysema of the neck and the supraclavicular region bilaterally. Before the patient's arrival, the surgical and anesthesia team had extensive discussion regarding the child's perioperative management, which included the need to maintain spontaneous ventilation to avoid opening the tracheal tear and producing a further increase in the size of the pneumomediastinum. The anesthesia machine was prepared for a general anesthetic along with a wide array of appropriately sized endotracheal tubes. In addition to appropriately sized laryngoscope blades, a fiberoptic scope and video laryngoscope were immediately available. Spontaneous respirations were maintained throughout the procedure, and the case proceeded uneventfully. This case represents the need for proper preparation and communication between providers to manage all possible scenarios of a traumatic tracheal tear.