Boston Bomber Intubated and Sedated

We are following news reports that the alleged Boston bomber Dzhokar Tsarnaev is currently intubated (breathing tube placed) and sedated, as we surmised earlier would be the case, with injuries to the “throat.” This is a medically imprecise description that would not be used by a trauma surgeon and in civilian parlance can mean one of several things. Likely it is an indication that he was injured by a gunshot wound to his trachea or esophagus. These are wounds that are not as immediately life-threatening as a gunshot wound to the carotid artery but can cause a longer and more difficult recovery. A gunshot wound to the trachea with a high caliber bullet would likely cause significant cartilage damage that will require extensive reconstruction by otolaryngologists and likely caused the placement of a tracheostomy. What is a key fact to be discerned is whether there was an injury to his larynx (voicebox) and if so, what the extent of the damage might be. Reconstructing a trachea without underlying damage to the voice structures is something well within the capabilities of the ENT staff at Beth Israel Deaconess Medical Center, as is reconstruction of the larynx if the damage is not too extensive. In the setting of complete destruction of the voice structures, artificial speaking devices can be used to produce simulated speech. Any reconstruction would be done at a later surgery date with the patient kept intubated and sedated until that time. Even in the setting of ...
Source: Inside Surgery - Category: Surgeons Authors: Tags: Critical Care Musings Trauma Surgery Beth Israel Deaconess bomb suspect boston Dzhokar injuries intubated sedated Tsarnaev wounds Source Type: blogs