Grande C M, Stene J K, Bernhard W N
Department of Anesthesiology, R Adams Cowley Shock Trauma Center, Maryland Institute for Emergency Medical Services Systems, Baltimore.
Crit Care Clin. 1990 Jan;6(1):37-59.
The five components integral to modern, sophisticated airway management in trauma patients include equipment, pharmacologic adjuncts, manual techniques, physical circumstances, and patient profile. Although there is a finite number of pieces and types of equipment, pharmacologic adjuncts, and manual techniques, the last two components are variable. For purposes of brevity and clarity, this article has presented definitive airway management in terms of a well-organized, fully-equipped admitting (resuscitation) area of a trauma center, but a trauma patient may require airway management in a variety of physical circumstances, including the field, the transport vehicle, and numerous locations within the trauma center. We believe that the commonly used airway management algorithms are a poor substitute for a conceptual understanding of the basic principles of the five components of airway management, although these decision trees may be useful as learning tools. The construction of a truly complete decision tree is virtually impossible because of the high number of individual patient profiles.
现代复杂创伤患者气道管理的五个不可或缺的组成部分包括设备、药物辅助、手动技术、身体状况和患者概况。尽管设备、药物辅助和手动技术的种类和数量有限,但后两个组成部分是可变的。为简洁明了起见,本文从创伤中心组织完善、设备齐全的收治(复苏)区域的角度介绍了确定性气道管理,但创伤患者可能需要在各种身体状况下进行气道管理,包括现场、运输车辆以及创伤中心内的众多地点。我们认为,尽管这些决策树作为学习工具可能有用,但常用的气道管理算法并不能很好地替代对气道管理五个组成部分基本原则的概念性理解。由于个体患者概况数量众多,构建一个真正完整的决策树几乎是不可能的。