Emergency awake tracheostomy for an impending upper airway obstruction in a child while beheading a live fish

Abstract

Disabling a live fish by biting the fish head is a traditional practice in developing countries like Fiji. It is a practice that should be abandoned to avoid death from the fish causing an acute upper airway obstruction. Despite the lack of infrastructure and challenges, emergency awake tracheostomy in a child can be done safely in an emergency situation under local anaesthetic with minimal sedation to secure the airway. It is feasible to do it in the rural or remote health centres by a surgeon before any attempt at removing the foreign body causing an impending upper airway obstruction. Alternatively, transfer to a tertiary centre for definitive treatment can be safely done once a definitive airway has been secured.