Laryngeal injury in a coronavirus disease 2019 caregiver following voluntary cough-holding within an inappropriately sized personal protective equipment suit. Issue 3 (28th March 2023)

• Record Type: Journal Article
• Authors: Dutta, M; Raghu, G
• Is Part Of: Journal of laryngology & otology. Volume 137:Issue 3(2023)
• Page Start: 342
• Page End: 349
• Publication Date: 2023-03-28
• Subjects: COVID-19 -- Pandemics -- Personal Protective Equipment -- Larynx; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1017/S0022215122001025
• Languages: English
• ISSNs: 0022-2151

Abstract

Abstract: Objective: To document laryngeal framework rupture following voluntary cough-holding as an airway complication of donning a personal protective equipment suit that was too small in size. Methods: Clinical record and literature review, with proposition of plausible aerodynamics of the airway injury. Results: Whilst carrying out his duty in the coronavirus disease ward, a resident attempted to stifle a paroxysm of cough when wearing a personal protective equipment suit that was too small with his neck flexed and restricted. There was a sudden release of pressure, intense pain and swelling in the neck with crepitus. Imaging revealed a non-displaced fracture in the lower end of the partially ossified right thyroid lamina, a cricothyroid membrane tear and subcutaneous emphysema. The symptoms resolved gradually on conservative management. Conclusion: This report underlines the importance of donning appropriately sized personal protective equipment and encouraging its proper use amongst coronavirus disease 2019 caregivers. Non-traumatic laryngeal injury, itself a rare event, has never been reported as a posture-related complication of wearing personal protective equipment.