Document Type : Case Report


1 Department of Emergency Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India

2 Department of Orthopedics, Aditya Birla Memorial Hospital, Thergaon, Chinchwad, Pune, Maharashtra, India

3 Department of Anatomy, Government Medical College, Nizamabad, Telangana, India


Objective: To demonstrate the significance of fused cervical vertebrae in emergency
medicine practice.
Case report: A 35-year-old male was brought to the emergency department (ED) who
attempted suicide by hanging and was later found to have congenital fusion of cervical
vertebra C2 and C3, a condition referred to as - vertebra critica. This is the only case report
of a patient with vertebra critica admitted for near hanging. The patient was intubated
with a Portex® North Polar endotracheal tube (ETT) through the nasal route. This proved to
be 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 resuscitation
without aggravating the neurological injuries. It must be noted that nasal intubation is
contraindicated in base of skull fractures and it should be avoided in patients with obvious
traumatic injury to the neck including laryngeal trauma, tracheal disruption and vessel


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