North Bristol NHS Trust, AAGBI Working Party, Bristol University, Bristol, UK.
Anaesthetics and Intensive Care Medicine, Severn Deanery, UK.
Anaesthesia. 2017 Mar;72(3):379-390. doi: 10.1111/anae.13779. Epub 2017 Jan 3.
Pre-hospital emergency anaesthesia with oral tracheal intubation is the technique of choice for trauma patients who cannot maintain their airway or achieve adequate ventilation. It should be carried out as soon as safely possible, and performed to the same standards as in-hospital emergency anaesthesia. It should only be conducted within organisations with comprehensive clinical governance arrangements. Techniques should be straightforward, reproducible, as simple as possible and supported by the use of checklists. Monitoring and equipment should meet in-hospital anaesthesia standards. Practitioners need to be competent in the provision of in-hospital emergency anaesthesia and have supervised pre-hospital experience before carrying out pre-hospital emergency anaesthesia. Training programmes allowing the safe delivery of pre-hospital emergency anaesthesia by non-physicians do not currently exist in the UK. Where pre-hospital emergency anaesthesia skills are not available, oxygenation and ventilation should be maintained with the use of second-generation supraglottic airways in patients without airway reflexes, or basic airway manoeuvres and basic airway adjuncts in patients with intact airway reflexes.
院前急救麻醉并经口气管插管是无法保持气道通畅或无法实现充分通气的创伤患者的首选技术。应尽快安全地进行，并按照院内急救麻醉的标准进行。仅应在具有全面临床治理安排的组织中进行。技术应简单、可重复、尽可能简单，并辅以检查表。监测和设备应符合院内麻醉标准。从业者需要有能力提供院内急救麻醉，并在进行院前急救麻醉之前接受过监督的院前经验。在英国，目前还没有允许非医师安全实施院前急救麻醉的培训计划。在无法获得院前急救麻醉技能的情况下，对于无气道反射的患者，应使用第二代声门上气道来维持氧合和通气，对于有完整气道反射的患者，应使用基本气道手法和基本气道辅助工具。
