Vertebra critica in a case of near-hanging

Objective: To demonstrate the significance of fused cervical vertebrae in emergency medicine practice. Case Presentation: A 35-year-old male was brought to the emergency department (ED) who attempted suicide by hanging and was later found to have congenital fusion of cervical vertebra C2 and C3, a condition referred to as - vertebra critica. This is the only case report of a patient with vertebra critica admitted for near hanging. The patient was intubated with a Portex® North Polar endotracheal tube (ETT) through the nasal route. This proved to be a critical decision as it helped early airway control avoiding any complication. Conclusion: As the victims of near-hanging should have cervical spine restriction, judicious use of flexible portex® ETT may help in early intubation and resuscitation without aggravating the neurological injuries. It must be noted that nasal intubation is contraindicated in base of skull fractures and it should be avoided in patients with obvious traumatic injury to the neck including laryngeal trauma, tracheal disruption and vessel injuries.