King Hwa-Kou
Department of Anesthesiology, Riverside County Regional Medical Center, Western University of Health Science, Riverside, California, USA.
Acta Anaesthesiol Sin. 2002 Sep;40(3):135-7.
Endotracheal intubation using a laryngoscope is the most rapid and usually the easiest means to ensure a patent airway. It has therefore earned its popularity in anesthesia and other acute health care practices. However, intubation by conventional technique is not always successful as at times direct vision of the glottis/vocal cords is impossible during laryngoscopy. Thus, acute airway obstruction remains a constant problem in all acute health care practices. To deal with this challenge, we have developed a new technique incorporating a modified Satin-Slip intubating stylet (Mallinckrodt Medical, St. Louis, MO, USA). First, cut the plastic sheath of the stylet at its distal end and push the sheath forward about one and a half inches. The soft plastic tip of the malleable stylet is then allowed to protrude from the endotracheal tube (ETT). When visualization of the glottic aperture is not possible, one simply places the soft plastic tip of the stylet under the epiglottis and advances it forward, and the tip will eventually enter the larynx. The ETT is then advanced off the stylet into the trachea. This new technique works very well in our experiences. It can be performed quickly with readily available inexpensive equipment. Our favorable experience leads us to believe it is one of the most promising additions to the current recommended alternatives.
使用喉镜进行气管插管是确保气道通畅最迅速且通常也是最简便的方法。因此,它在麻醉及其他急性医疗实践中颇受欢迎。然而,传统技术插管并非总能成功,因为有时在喉镜检查过程中无法直接看到声门/声带。所以,急性气道梗阻在所有急性医疗实践中始终是个问题。为应对这一挑战,我们研发了一种新技术,该技术结合了改良的缎面滑动插管探条(美国密苏里州圣路易斯市 Mallinckrodt 医疗公司生产)。首先,在探条远端切断其塑料护套,并将护套向前推约 1.5 英寸。然后让可塑探条的柔软塑料尖端从气管内导管(ETT)伸出。当无法看到声门裂时,只需将探条的柔软塑料尖端置于会厌下方并向前推进,尖端最终会进入喉部。接着将 ETT 顺着探条推进气管。根据我们的经验,这项新技术效果很好。它可以使用现成的廉价设备快速完成。我们良好的经验使我们相信,它是当前推荐替代方法中最有前景的补充方法之一。