Baum J A, Sachs G, Stanke H-G
Abteilung für Anästhesie und Intensivmedizin, Krankenhaus St. Elisabeth-Stift, Damme.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2004 Oct;39(10):610-5. doi: 10.1055/s-2004-825952.
The skill to safely manage the unexpectedly difficult airway is expected from every anaesthetist. The strategies to safely overcome this severe problem have to be adapted to the given equipment and the individual aptitude and skills of the respective colleague. The algorithms for management of the difficult airway should be as simple as possible, and one cannot assume that devices for fibre-optic intubation are available at every site. Indispensable, however, is the availability of face masks, naso- and oropharyngeal airways and laryngeal mask airways in different sizes at each induction site. This paper is especially devoted to recalling the Oxford non-kinking tube and its specific way of handling, as a lot of cases of unexpectedly difficult airway can be safely managed with this tool. Alternatives to safeguarding the difficult airway are the intubation laryngeal mask airway or the esophago-tracheal combitube. For managing the worst case, the "cannot ventilate - cannot intubate" disaster, instruments for percutaneous punction of the trachea and devices for oxygen insufflation must be readily available in every theatre.
每位麻醉医生都应具备安全处理意外困难气道的技能。安全克服这一严重问题的策略必须根据现有设备以及各同事的个人能力和技能进行调整。困难气道管理算法应尽可能简单，而且不能假定每个地点都有纤维光导插管设备。然而，每个诱导地点必须备有不同尺寸的面罩、鼻咽通气道、口咽通气道和喉罩气道。本文特别致力于回顾牛津无扭结导管及其特殊操作方法，因为使用该工具可安全处理许多意外困难气道病例。处理困难气道的替代方法是插管型喉罩气道或食管气管联合导管。为应对最糟糕的情况，即“无法通气 - 无法插管”灾难，每个手术室都必须随时备有经皮气管穿刺器械和氧气吹入装置。
