Not all mucous plugs are created equal!

Mucous plug related airway obstruction is a very common clinical problem in patients on endotracheal tube and tracheostomy tube (TT). The obstruction can be catastrophic in smaller children where the lumen of the artificial airway is already small to begin with and any minimal mucous plug can produce a complete obstruction. We present the case of a mucous plug related complete airway obstruction which encountered no resistance with passage of a suction catheter, but rather was found to be acting like a ball valve.

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