Leal-Pavey Yolanda R
Deaconess Medical Center, Spokane, WA, USA.
AANA J. 2004 Dec;72(6):427-30.
In addition to managing the most challenging of airways within the operating room environment, anesthesia providers are frequently consulted or requested to participate in emergency airway control in various areas of the hospital, often after other providers have failed. The following is a case report of a premature infant born with multiple and life threatening congenital anomalies in a rural facility. The current recommendations of the American Heart Association for neonatal resuscitation were followed; however, the resuscitating team was unable to secure the airway using standard intubating techniques. Consultation with the anesthetist on duty resulted in the successful placement of the laryngeal mask airway (LMA) size 1. The pediatrician involved in the care of the patient had minimal experience with using the LMA; however, with verbal instruction was able to successfully place the LMA. With a patent airway established, the patient stabilized and was transferred to a tertiary facility for aggressive care. Although currently not part of the American Heart Association neonatal resuscitation algorithm, consideration of the LMA as a tool to manage an airway after failed attempts at intubation may be appropriate.
除了在手术室环境中处理最具挑战性的气道问题外，麻醉医护人员还经常被咨询或要求参与医院各个区域的紧急气道控制，通常是在其他医护人员尝试失败之后。以下是一个病例报告，一名早产儿在一家农村医疗机构出生，患有多种危及生命的先天性畸形。遵循了美国心脏协会目前关于新生儿复苏的建议；然而，复苏团队无法使用标准插管技术确保气道通畅。与值班麻醉医生协商后，成功置入了1号喉罩气道（LMA）。参与该患者护理的儿科医生使用LMA的经验极少；然而，通过口头指导，能够成功置入LMA。建立了通畅气道后，患者病情稳定，被转至三级医疗机构接受积极治疗。尽管目前LMA并非美国心脏协会新生儿复苏流程的一部分，但在插管尝试失败后将LMA作为管理气道的工具加以考虑可能是合适的。
