I’m breathless – is it a bad chest?

What is the most likely underlying diagnosis?

His notes reveal he was seen in maxillofacial (Max Fax) clinic very recently- complaining of shortness of breath and weight loss. A nasoendosocpy revealed a large base of tongue swelling and possible recurrence. He is awaiting MDT discussion and a possible elective tracheostomy.

You return to the patient to ask about the clinic visit. He deteriorates rapidly, with worsening stridor, respiratory distress and requiring 15L oxygen through a non rebreathe.

What are the appropriate next steps in his management? (Select all that apply)

The patient fails to respond to temporising treatments and goes into cardiac arrest. Advanced Life Support (ALS) protocols are commenced appropriately. There is a senior anaesthetic registrar at the airway. She is unable to ventilate the patient using a two handed BVM technique. Using video laryngoscopy, the best view she obtains is a grade 4.

What should the team’s next action be?