Avnstorp M B, Jensen P V F, Dzongodza T, Matinhira N, Chidziva C, Melchiors J, Von Buchwald C
Department of Otorhinolaryngology,Head and Neck Surgery and Audiology,Rigshospitalet,Copenhagen,Denmark.
Department of Otorhinolaryngology,Parirenyatwa Hospital,Harare,Zimbabwe.
J Laryngol Otol. 2016 Oct;130(10):923-927. doi: 10.1017/S0022215116008719. Epub 2016 Sep 9.
In developing countries with limited access to ENT services, performing emergency cricothyroidotomy in patients with upper airway obstruction may be a life-saving last resort. An established Danish-Zimbabwean collaboration of otorhinolaryngologists enrolled Zimbabwean doctors into a video-guided simulation training programme on emergency cricothyroidotomy. This paper presents the positive effect of this training, illustrated by two case reports.
A 56-year-old female presented with upper airway obstruction due to a rapidly progressing infectious swelling of the head and neck progressing to cardiac arrest. Cardiopulmonary resuscitation was initiated and a secure surgical airway was established via an emergency cricothyroidotomy, saving the patient. A 70-year-old male presented with upper airway obstruction secondary to intubation for an elective procedure. When extubated, the patient exhibited severe stridor followed by respiratory arrest. Re-intubation attempts were unsuccessful and emergency cricothyroidotomy was performed to secure the airway, preserving the life of the patient.
Emergency cricothyroidotomy training should be considered for all surgeons, anaesthetists and, eventually, emergency and recovery room personnel in developing countries. A video-guided simulation training programme on emergency cricothyroidotomy in Zimbabwe proved its value in this regard.
在耳鼻喉科服务有限的发展中国家，对上呼吸道梗阻患者实施紧急环甲膜切开术可能是挽救生命的最后手段。丹麦和津巴布韦的耳鼻喉科医生建立了合作关系，将津巴布韦医生纳入了一项关于紧急环甲膜切开术的视频引导模拟培训计划。本文通过两个病例报告展示了该培训的积极效果。
一名56岁女性因头颈部迅速进展的感染性肿胀导致上呼吸道梗阻，并进展为心脏骤停。立即进行心肺复苏，并通过紧急环甲膜切开术建立了安全的手术气道，挽救了患者生命。一名70岁男性在择期手术插管后出现上呼吸道梗阻。拔管时，患者出现严重喘鸣，随后呼吸骤停。再次插管尝试失败，遂进行紧急环甲膜切开术以确保气道通畅，保住了患者性命。
发展中国家的所有外科医生、麻醉师以及最终的急诊和恢复室人员都应考虑接受紧急环甲膜切开术培训。津巴布韦开展的关于紧急环甲膜切开术的视频引导模拟培训计划在这方面证明了其价值。
