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Stridor and Down’s syndrome
  1. M Gutenstein
  1. Correspondence to:
 Dr M Gutenstein, Accident and Emergency Department, Frenchay Hospital, Bristol BS161LE, UK; 

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A 36 year old woman with Down’s syndrome and hypothyroidism presented to the emergency department with breathlessness. She had suffered with coryzal symptoms for a week, before becoming increasingly dyspnoeic the day before presentation. On arrival she was unable to speak and stridulous. She was neither drooling nor toxic. Her temperature was 37.4°C. However oxygen saturation was reduced and arterial blood gas measurement showed a type 2 respiratory failure with acidosis. An urgent anaesthetic opinion was sought, and the patient transferred to the resuscitation room. Fibreoptic laryngoscopy confirmed the suspicion of a supraglottitis. After inhalation induction using sevofluorane, intubation was achieved with difficulty. …

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