An anesthesiologist is called to the ICU for an airway problem. He arrives and finds an 86-year-old man unable to stop coughing. The nurse said she had been encouraging him to take deep breaths, when he suddenly started to cough. His oxygen saturation is 86% and he does not want the oxygen mask on his face. He is sitting up and looks like he is fighting for his life. He is holding onto his neck but cannot tell you what the problem is. He won’t open his mouth.
He is in the ICU, recovering from the removal of a subdural hematoma performed 3 days ago. He got this after falling down a few stairs at home. The surgery was performed under local anesthesia which he tolerated well. The anesthesiologist checks the anesthetic record which is noncontributory to the problem at hand. He orders a chest X-ray but really does not know what he is looking for. He is really at a loss as to what to do.…
