Difficult Airway Management in a Case of Hair Dye Poisoning

There is no doubt regarding the significance of establishing a patent airway in the critically ill patient in the Emergency Department. Failure to secure the airway can drastically increase the morbidity and mortality of the patient within few minutes. Cannot intubate and cannot ventilate situation is a nightmare to all emergency physicians. Hence, knowledge of alternative measures to secure the airway and ventilate the patient is necessary. Prompt decision to proceed for emergency surgical airway (cricothyroidotomy or tracheostomy) is one of the utmost important rescue measures under such circumstances. Hesitating to perform this procedure may lead to repeated unsuccessful attempts at oral-tracheal intubation and inadvertently, to hypoxia and subsequent brain damage and death. We report a fatal case of hair dye poisoning that presented with severe angioedema and airway compromise.