Melker Jeremy S, Gabrielli Andrea
Department of Otolaryngology, University of Florida College of Medicine, Gainesville, Florida, USA.
Ann Otol Rhinol Laryngol. 2005 Jul;114(7):525-8. doi: 10.1177/000348940511400705.
Emergent cricothyrotomy is a potentially lifesaving procedure central to acute airway algorithms. In most cases in which cricothyrotomy is indicated, the acuteness of the airway precludes subspecialty consultation before performance of the procedure. The academic environment is an exception, in which the responsibility of securing a "difficult" cricothyroid airway may fall upon junior otolaryngology residents. Described here is the use of the Melker Emergency Cricothyrotomy Kit, a prepackaged kit that uses a wire-guided percutaneous dilational technique (the Seldinger technique) and a procedure-specific polyvinylchloride airway catheter. The wire-guided technique may add a margin of safety for a relatively inexperienced resident performing cricothyrotomy. Furthermore, a newly released version of the kit includes instrumentation for insertion of the Melker airway catheter by the classic surgical technique in addition to that required for the Seldinger technique, which may enable even a seasoned surgeon to secure the airway faster and more safely.
紧急环甲膜切开术是急性气道处理流程中的一项可能挽救生命的关键操作。在大多数需要进行环甲膜切开术的情况下，气道的紧急状况使得在实施该操作前无法进行专科会诊。学术环境是个例外，在这种情况下，确保“困难”的环甲膜气道安全的责任可能落在初级耳鼻喉科住院医师身上。本文介绍了Melker紧急环甲膜切开术套件的使用，这是一种预包装套件，采用导丝引导的经皮扩张技术（Seldinger技术）和特定手术用的聚氯乙烯气道导管。对于相对缺乏经验的住院医师进行环甲膜切开术而言，导丝引导技术可能会增加一定的安全边际。此外，该套件的新版本除了包含Seldinger技术所需器械外，还配备了通过经典手术技术插入Melker气道导管的器械，这甚至可能使经验丰富的外科医生能更快、更安全地确保气道通畅。
