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Korean Journal of Anesthesiology 1977;10(2):195-198.
DOI: https://doi.org/10.4097/kjae.1977.10.2.195   
Cardiac Arrest during Tracheostomy Cannula Misplacement - A Case of Diphtheria.
Young Moon Han
Department of Anesthesiology, Holy Family Hospital, Catholic Medical College, Seoul, Korea.
Abstract
A case of sudden cardiac arrest due to misplaced tracheostomy cannula was reviewed. The genera1 condition of the patient was febrile, dyspneic and acutely ill. Emergency tracheostomy was performed under ketamine-halothane endotracheal anesthesia. Sudden cardiac arrest was noticed when a metal cannula was inserted through the tracheostomy site by the surgeon after the tracheostomy. Immediate closed chest cardiac massage was performed successfully.


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