Visvanathan T, Kluger M T, Webb R K, Westhorpe R N
Department of Anaesthesia, The Queen Elizabeth Hospital, Woodville, South Australia, Australia.
Qual Saf Health Care. 2005 Jun;14(3):e2. doi: 10.1136/qshc.2002.004325.
Obstruction of the natural airway, while usually easily recognised and managed, may present simply as desaturation, have an unexpected cause, be very difficult to manage, and have serious consequences for the patient.
To examine the role of a previously described core algorithm "COVER ABCD-A SWIFT CHECK", supplemented by a specific sub-algorithm for obstruction of the natural airway, in the management of acute airway obstruction occurring in association with anaesthesia.
The potential performance for this structured approach for each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved.
There were 62 relevant incidents among the first 4000 reports to the AIMS. It was considered that the correct use of the structured approach would have led to earlier recognition of the problem and/or better management in 11% of cases.
Airway management is a fundamental anaesthetic responsibility and skill. Airway obstruction demands a rapid and organised approach to its diagnosis and management and undue delay usually results in desaturation and a potential threat to life. An uncomplicated pre-learned sequence of airway rescue instructions is an essential part of every anaesthetist's clinical practice requirements.
自然气道梗阻虽然通常易于识别和处理，但可能仅表现为血氧饱和度下降，病因不明，处理起来非常困难，并给患者带来严重后果。
探讨先前描述的核心算法“COVER ABCD-A SWIFT CHECK”，辅以自然气道梗阻的特定子算法，在处理与麻醉相关的急性气道梗阻中的作用。
将澳大利亚事件监测研究（AIMS）报告的前4000起相关事件中这种结构化方法的潜在表现与参与的麻醉医生报告的实际处理情况进行比较。
在向AIMS报告的前4000份报告中有62起相关事件。据认为，正确使用结构化方法可使11%的病例更早发现问题和/或得到更好的处理。
气道管理是麻醉的一项基本职责和技能。气道梗阻需要快速且有条理的方法来进行诊断和处理，不当延误通常会导致血氧饱和度下降并对生命构成潜在威胁。一套简单易记的气道急救指令序列是每位麻醉医生临床实践要求的重要组成部分。
