Effective Use of a Combined Video Laryngoscope and Bronchoscope System in the Emergency Department for a Patient With Severe Upper Airway Obstruction Due to Angioedema: A Case Report

Management of difficult airways in the emergency department is challenging. Herein, we report a case of successful management of severe upper airway obstruction caused by angioedema, where intubation was achieved using a dual-function video laryngoscope and bronchoscope system in the emergency department for a patient with severe upper airway stenosis due to angioedema. A 74-year-old obese man with dyspnea presented to our emergency department. Despite initial attempts using a conventional intubation technique, the patient's airway remained difficult to manage because of marked enlargement of the tongue. The anesthesiologists decided to apply the dual-function video laryngoscope and bronchoscope system (GlideScope Core System™, Verathon Inc., Bothell, WA, USA). Finally, nasotracheal intubation was successfully performed using a bronchoscope switched from a video laryngoscope. The patient's respiratory status improved post-intubation. Subsequent management proceeded uneventfully. The patient was transferred to the ICU, where he was diagnosed with angioedema after admission.