Search

The first wave of the COVID-19 pandemic affected health in all domains i.e., physical, mental, and social aspects. Liver transplant (LT) recipients faced a multitude of challenges during the first wave of lockdown. The aim was to identify the psychosocial difficulties and quality of life during the first year of the pandemic.A cross-sectional survey was conducted on LT recipients with a predefined structured questionnaire that included clinical, COVID-19 anxiety scale, and Post-Transplant Quality of life questionnaire (pLTQ).A total of 109 patients were studied; with a mean age of 50.5 ± 11.1 years, with a median post-transplant follow-up of 52.4 months and a live donor transplant in the majority (79.8%). Almost all (99.1%) could come to the hospital for regular follow-up, prior to the pandemic. But during the first wave only 57% could maintain planned hospital visits and about 88% could not pursue their regular activities, and 39% missed their routine exercise because of imposed restrictions. Similarly, financial implications were responsible for 4% defaulting from treatment; while 7.3% managed by curtailing supportive drugs (on their own) leading to deranged liver tests in 4.6%; requiring immediate attention. The psychosocial difficulties raised the stress of pandemic (median score 18), and impacted quality of life (mean total pLTQ score 4.7 ± 0.9).For LT recipients, the first wave of COVID-19 pandemic affected their physical, mental, financial, and social wellbeing; in addition to the disease itself. Awareness, psychosocial support, and comprehensive care are some unmet needs for this special group; especially when it is expected that subsequent waves may continue to occur.

Airway management in polytrauma patients can create unanticipated challenges, particularly in the presence of tracheal injury. A 24-year-old male who suffered a road traffic accident was diagnosed with complete tracheal disruption with a gap of 3.5 cm with minimal external signs of injury. Initial intubation attempts revealed resistance at 18 cm from the angle of the mouth with the endotracheal tube creating a visible contour just below the skin in the midline of the neck. Associated palpable crepitus in the neck led to the suspicion of tracheal disruption. The patient was then intubated using a bougie. The tube was pushed into the bronchus distal to the suspected gap and then withdrawn to lie just above the carina, thereby providing adequate ventilation and preventing further development of subcutaneous emphysema. Associated injuries were managed by multidisciplinary consultations. Prompt thinking and quick clinical decisions with respect to the airway proved to be life-saving for the patient.