Bonanno Fabrizio Giuseppe
Trauma Directorate, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.
J Emerg Trauma Shock. 2012 Apr;5(2):153-9. doi: 10.4103/0974-2700.96485.
An algorithm on the indications and timing for a surgical airway in emergency as such cannot be drawn due to the multiplicity of variables and the inapplicability in the context of life-threatening critical emergency, where human brain elaborates decisions better in cluster rather than in binary fashion. In particular, in emergency or urgent scenarios, there is no clear or established consensus as to specifically who should receive a tracheostomy as a life-saving procedure; and more importantly, when. The two classical indications for emergency tracheostomy (laryngeal injury and failure to secure airway with endotracheal intubation or cricothyroidotomy) are too generic and encompass a broad spectrum of possibilities. In literature, specific indications for emergency tracheostomy are scattered and are biased, partially comprehensive, not clearly described or not homogeneously gathered. The review highlights the indications and timing for an emergency surgical airway and gives recommendations on which surgical airway method to use in critical airway.
由于变量的多样性以及在危及生命的紧急情况下不适用，因此无法制定出这样一种关于紧急情况下手术气道的适应症和时机的算法，在这种危及生命的紧急情况下，人脑以集群方式而非二元方式做出决策会更好。特别是在紧急或紧迫的情况下，对于具体谁应该接受气管切开术作为一种挽救生命的手术，以及更重要的是何时进行，并没有明确或既定的共识。紧急气管切开术的两个经典适应症（喉部损伤以及气管插管或环甲膜切开术无法确保气道安全）过于宽泛，涵盖了广泛的可能性。在文献中，紧急气管切开术的具体适应症分散且有偏差，部分内容不全面，描述不清晰或未统一汇总。本综述强调了紧急手术气道的适应症和时机，并就危急气道应采用哪种手术气道方法给出了建议。
