Jagannathan Narasimhan, Wong David T
Department of Pediatric Anesthesiology, Children's Memorial Hospital, Northwestern University's Feinberg School of Medicine, Chicago, Illinois 60614, USA.
J Emerg Med. 2011 Oct;41(4):369-73. doi: 10.1016/j.jemermed.2010.05.066. Epub 2010 Aug 30.
This case report describes the use of the air-Q intubating laryngeal airway (air-Q ILA; Cookgas LLC, St. Louis, MO) for airway rescue and a conduit for blind tracheal intubation in two pediatric patients with failed rapid sequence intubation and difficult airways secondary to airway bleeding in the emergency department (ED).
To describe the use of a new supraglottic rescue device in the management of the pediatric patient's difficult airway in the emergency setting.
Case 1 was a 5-year-old boy who presented to the ED for bleeding one day after his tonsillectomy. After a rapid sequence intubation, direct laryngoscopy was difficult, with copious bleeding in the oropharynx and inability to visualize the glottis. After two failed direct laryngoscopic attempts to intubate, a size-2 air-Q ILA was inserted. A cuffed 5.0-mm inner diameter (ID) endotracheal tube (ETT) was blindly inserted through the lumen of the air-Q ILA into the trachea successfully. Case 2 was a 13-year-old boy who presented to the ED with a large nasopharyngeal laceration from a motor vehicle accident. After a rapid sequence intubation, direct laryngoscopy showed copious blood with no glottic visualization. A size 3 Laryngeal Mask Airway Classic™ (cLMA; LMA North America Inc., San Diego, CA) was inserted with a large airway leak, and blind ETT insertion via the cLMA was unsuccessful. Subsequently, a size-2.5 air-Q ILA was inserted and adequate ventilation was restored. A cuffed 6.0-mm ID ETT was blindly inserted through the air-Q ILA into the trachea successfully.
Two cases of failed laryngoscopy in pediatric patients with blood in the airway are described. In each case, insertion of an air-Q ILA was followed by successful blind tracheal intubation via the lumen of the air-Q ILA.
本病例报告描述了在两名儿科患者中使用Air-Q气管插管喉罩（Air-Q ILA；Cookgas LLC，密苏里州圣路易斯）进行气道救援以及作为盲探气管插管通道的情况，这两名患者在急诊科（ED）因气道出血导致快速顺序插管失败且气道困难。
描述一种新型声门上救援设备在急诊环境中处理儿科患者困难气道的应用。
病例1是一名5岁男孩，扁桃体切除术后一天因出血就诊于急诊科。快速顺序插管后，直接喉镜检查困难，口咽大量出血，无法看到声门。两次直接喉镜插管尝试失败后，插入了2号Air-Q ILA。一根带套囊的内径5.0毫米的气管内导管（ETT）通过Air-Q ILA的管腔成功盲插入气管。病例2是一名13岁男孩，因机动车事故导致鼻咽部大裂伤就诊于急诊科。快速顺序插管后，直接喉镜检查显示大量血液，看不到声门。插入了一个3号经典喉罩气道（cLMA；LMA北美公司，加利福尼亚州圣地亚哥），气道漏气严重，通过cLMA盲插ETT未成功。随后，插入了2.5号Air-Q ILA，恢复了充分通气。一根带套囊的内径6.0毫米的ETT通过Air-Q ILA成功盲插入气管。
描述了两例气道内有血液的儿科患者喉镜检查失败的病例。在每例中，插入Air-Q ILA后均通过其管腔成功进行了盲探气管插管。
