Submitted by Dr Tang Kam Shing on 20 May 2009; ICU, Tuen Mun Hospital, Hong Kong
This M/55 had long history of COPD and poor lung function. He was admitted for COPD exacerbation due to pneumonia. He was intubated but failed to wean from the ventilator. Percutaneous tracheostomy was decided upon. USG neck was done before tracheostomy and is shown in this picture at the level of C1-C2. Will you proceed with the procedure?
Answer: This picture shows a big vessel going around the trachea at the site that was originally marked for puncture. As a result, we avoided the site and went down one level. USG at that level showed no vessel and the procedures was successfully done.