de Koning Gans J M Margot, Zwart Dorien L M, Kalkman Cor J
Universitair Medisch Centrum Utrecht (UMCU), Kenniscentrum Patiëntveiligheid, Utrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1299.
Acute upper-airway obstructions, especially epiglottitis, are being observed with increasing frequency in adults, both in the hospital situation and in general practice. Acute upper-airway obstructions are life-threatening and therefore need to be treated with the highest priority. When interventions such as manual removal of a foreign body, thoracic compression or the Heimlich manoeuvre fail, the only remaining interventions are intubation and cricothyrotomy. However, only a few general practitioners (GPs) are skilled enough to perform these procedures. Should all GPs be trained in performing life-saving interventions such as cricothyrotomy? This is a difficult question; the intervention is invasive and has a high risk of complications, but securing the airway is a critical life-saving measure. Above all, there is very limited time available to wait for more experienced help. Therefore, we believe that GPs should be trained in performing life-saving interventions such as cricothyrotomy.
急性上呼吸道梗阻,尤其是会厌炎,在医院环境和普通医疗实践中,在成人中观察到的频率越来越高。急性上呼吸道梗阻危及生命,因此需要最优先进行治疗。当诸如手动取出异物、胸部按压或海姆立克急救法等干预措施失败时,唯一剩下的干预措施就是插管和环甲膜切开术。然而,只有少数全科医生(GP)有足够的技能来执行这些操作。所有全科医生都应该接受如环甲膜切开术等挽救生命的干预措施的培训吗?这是一个难题;这种干预具有侵入性且并发症风险高,但确保气道通畅是一项关键的救命措施。最重要的是,等待更有经验的帮助的时间非常有限。因此,我们认为全科医生应该接受如环甲膜切开术等挽救生命的干预措施的培训。