ACTRN12613000587707.

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Perforation of pharyngeal soft tissues on intubation is rare. We present a case where the endotracheal tube punctured the palatoglossal fold before passing into the trachea. The patient was ventilated for eight days in intensive care before identification of the complication. It is difficult to estimate the frequency of pharyngeal perforation as it rarely occurs. There is however, an increased incidence in difficult intubations, emergency airway management, inexperienced operators and technique used.

SummaryThe prevalence of latex allergy has increased since the 1980s. As latex is found throughout hospitals and operating theatres, careful planning is required for latex-allergic patients who present pre-operatively. We conducted a postal survey of 269 departments of anaesthesia in England and Wales; responses were received from 208 (77%). Of these, 198 (95%) had a latex allergy protocol and 181 (87%) had a store of latex-free equipment. Only 113 (54%) had a named nurse and 58 (28%) had a named consultant responsible for the update of latex allergy provisions. Access to allergy clinics and further investigations were available to 189 (91%). Many respondents called for national guidelines. We are reassured that the majority of trusts have an up-to-date latex allergy protocol and latex-free equipment store. However, relatively few have nominated members of staff responsible for these and peri-operative care of susceptible patients.