Rich James M, Mason Andrew M, Ramsay Michael A E
Baylor University, Medical Center, Dallas, TX, USA.
AANA J. 2004 Dec;72(6):431-9.
Advanced airway practitioners in anesthesiology, emergency medicine, and prehospital care can suddenly and unexpectedly face difficult airway situations that can surface without warning during mask ventilation or tracheal intubation. Although tracheal intubation remains the "gold standard" in airway management, it is not always achievable, and, when it proves impossible, appropriate alternative interventions must be used rapidly to avoid serious morbidity or mortality. The SLAM Emergency Airway Flowchart (SEAF) is intended to prevent the 3 reported primary causes of adverse respiratory events (ie, inadequate ventilation, undetected esophageal intubation, and difficult intubation). The 5 pathways of the SEAF include primary ventilation, rapid-sequence intubation, difficult intubation, rescue ventilation, and cricothyrotomy. It is intended for use with adult patients by advanced airway practitioners competent in direct laryngoscopy, tracheal intubation, administration of airway drugs, rescue ventilation, and cricothyrotomy. The SEAF has limitations (eg, suitable only for use with adult patients, cannot be used by certain categories of rescue personnel, and depends heavily on assessment of Spo2). A unique benefit is provision of simple alternative techniques that can be used when another technique fails.
麻醉学、急诊医学和院前急救领域的高级气道从业者可能会突然意外地面临困难气道情况，这些情况可能在面罩通气或气管插管过程中毫无征兆地出现。尽管气管插管仍然是气道管理的“金标准”，但并非总是能够成功实施，而且当证明无法插管时，必须迅速采用适当的替代干预措施以避免严重的发病或死亡。SLAM紧急气道流程图（SEAF）旨在预防报告的导致不良呼吸事件的3个主要原因（即通气不足、未被发现的食管插管和困难插管）。SEAF的5条路径包括初级通气、快速顺序插管、困难插管、救援通气和环甲膜切开术。它供具备直接喉镜检查、气管插管、气道药物给药、救援通气和环甲膜切开术能力的高级气道从业者用于成年患者。SEAF有局限性（例如，仅适用于成年患者，某些类别的救援人员不能使用，并且严重依赖于对脉搏血氧饱和度（Spo₂）的评估）。一个独特的优点是提供了简单的替代技术，当另一种技术失败时可以使用。
