Celiker Varol, Başgül Elif
Hacettepe university Medical School, Department of Anesthesiology and Reanimation, Sihhiye-Ankara.
Ulus Travma Acil Cerrahi Derg. 2005 Apr;11(2):89-95.
Knowledge of trauma is as old as mankind and survived a long way to reach new technologic developments. Being a multisystemic disease, trauma is an important social and financial problem especially in developing countries. Anesthesists possess important roles in the multisystemic management of trauma patients. In our country prehospital life support for trauma victims is primarily realized and arranged by the emergency help and rescue team 112 which belonged to the Ministry of Health. Several courses are arranged for the team especially about endotracheal intubation and resuscitation in the field. Acute major airway injuries require an early diagnosis and a prompt treatment to improve their outcomes. Typical injuries causing alterations in oxygenation or ventilation are head, spinal cord and thoracic traumas. The use of cuffed tracheal tube remains the definitive 'gold standard' for airway control. Tracheal tube placement requires experience and high degree of skill. The laryngeal mask airway, intubating laryngeal mask airway and oesophageal-tracheal combitube are also indicated in maintaining control of airway during emergency trauma patients in the field. A probable occurrence of cervical spine fracture must be assumed while maintaining airway patency. On-site airway aspiration, and monitoring of carbon dioxide must be realized in trauma victims.
创伤知识与人类历史一样悠久，并经历了漫长的发展历程才迎来新的技术进步。作为一种多系统疾病，创伤尤其是在发展中国家是一个重要的社会和经济问题。麻醉医生在创伤患者的多系统管理中发挥着重要作用。在我国，创伤受害者的院前生命支持主要由隶属于卫生部的急救与救援团队112来实施和安排。该团队会安排多个课程，特别是关于现场气管插管和复苏的课程。急性严重气道损伤需要早期诊断和及时治疗以改善预后。导致氧合或通气改变的典型损伤包括头部、脊髓和胸部创伤。使用带套囊气管导管仍然是气道控制的决定性“金标准”。气管导管置入需要经验和高度的技能。喉罩气道、插管型喉罩气道和食管气管联合导管也适用于在现场紧急创伤患者中维持气道控制。在保持气道通畅时必须假定可能发生颈椎骨折。必须对创伤受害者进行现场气道吸引和二氧化碳监测。
