Vertebra critica in a case of near-hanging

Objective: To demonstrate the significance of fused cervical vertebrae in emergencymedicine practice.Case report: A ۳۵-year-old male was brought to the emergency department (ED) whoattempted suicide by hanging and was later found to have congenital fusion of cervicalvertebra C۲ and C۳, a condition referred to as - vertebra critica. This is the only case reportof a patient with vertebra critica admitted for near hanging. The patient was intubatedwith a Portex® North Polar endotracheal tube (ETT) through the nasal route. This proved tobe a critical decision as it helped early airway control avoiding any complication.Conclusion: As the victims of near-hanging should have cervical spine restriction,judicious use of flexible portex® ETT may help in early intubation and resuscitationwithout aggravating the neurological injuries. It must be noted that nasal intubation iscontraindicated in base of skull fractures and it should be avoided in patients with obvioustraumatic injury to the neck including laryngeal trauma, tracheal disruption and vesselinjuries.

Keywords:

Emergency medicine , Traumatic spinal injury , Resuscitation , Trauma , Neurology