A cautionary tale of an emergency cerebrovascular procedure in the COVID-19 era

The coronavirus disease 2019 pandemic has had an impact on system processes, with airway management being significantly affected. A 37-year-old woman diagnosed with stroke was found to have a filling defect at the origin of the right internal carotid artery. She was taken to the operating room urgently for carotid endarterectomy. The procedure was uneventful; however, anaphylaxis developed on extubation, subsequently attributed to sugammadex. Institutional policies and limited resources resulted in delayed reintubation. Fortunately, she did not have lasting deficits, but this highlights the potential of current policies to lead to complications and the need to improve policies to minimize harm.