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Jaw Wired Shut? No Problem.

Airway management is full of unexpected emergencies. One of them is what to do if your patient has an airway emergency while their jaw is wired shut. This airway scenario is rare but it happens! Like it did to me a few years back when patient with facial trauma, status post ORIF of his broken mandible, began to have sudden spontaneous bleeding within the oropharynx about 10 days after surgery.

I had not thought to stock our difficult airway cart with wire cutters before then, and had to ask someone to run and get them while we waited anxiously for them to arrive. After I cut the wires and got the bleeding stopped, I felt pretty good about the save, but not so great about the lack of preparation, so I made sure that those wire cutters were in our difficult airway cart from then on.

Then just recently I learned that you don’t need those wire cutters after all! A friend of mine, Andy Vu from OMFS explained that all you needed was a little knowledge and a needle driver or Kelly clamp to break those wires and save a life!

After that we decided to include a little demo of this technique at one of our PAC Live!! events. Here is the short video of that demonstration. Go ahead and take a couple of minutes to let Andy walk you though this simple technique. No wire cutters required! Sorry for the audio. We’ll do better next time…

Congratulations on completing this learning space! You could stop here, but why would you want to? Look for more Situationally Difficult Airway (SDA) learning spaces and add another bundle of concepts, tools, and skills your airway tool box 🧰