Miklus R M, Elliott C, Snow N
Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.
J Trauma. 1989 Apr;29(4):506-8.
A retrospective analysis of 3,500 helicopter missions revealed 20 patients who required cricothyrotomy in the field for emergency airway access. Five patients who were in cardiopulmonary arrest succumbed despite cricothyrotomy, all with adequate airway control (Trauma Score, 2.8; ISS, 55.6). Seven of 12 patients with oral, maxillofacial, or cervical trauma survived (Trauma Score, 9.6; ISS, 48.25). There were no instances of bleeding, malposition, airway obstruction, or dysphonia after decannulation in the survivors. Autopsy revealed no serious airway pathology or compromise in those who expired. Surgical cricothyrotomy can successfully be performed in the field by a nurse/physician helicopter transport team. When conventional airway maneuvers are unsuccessful we recommend cricothyrotomy for emergency airway access.
对3500次直升机救援任务的回顾性分析显示，有20名患者在现场需要进行环甲膜切开术以建立紧急气道。5名心脏骤停患者尽管接受了环甲膜切开术仍死亡，所有患者气道控制均良好（创伤评分2.8；损伤严重度评分55.6）。12名口腔、颌面或颈部创伤患者中有7名存活（创伤评分9.6；损伤严重度评分48.25）。幸存者拔管后未出现出血、位置不当、气道阻塞或发声困难的情况。尸检显示，死亡患者未发现严重的气道病变或功能受损。护士/医生直升机运输团队可在现场成功实施外科环甲膜切开术。当传统气道操作不成功时，我们建议进行环甲膜切开术以建立紧急气道。
