创伤气道管理：诱导药物、快速与慢速顺序插管及特殊注意事项

Trauma Airway Management: Induction Agents, Rapid Versus Slower Sequence Intubations, and Special Considerations.

作者信息

Estime Stephen R, Kuza Catherine M

机构信息

Department of Anesthesiology and Critical Care, University of Chicago Medicine, 5841 South Maryland Avenue, MC-4028, Chicago, IL 60637, USA.

Department of Anesthesiology and Critical Care, Keck School of Medicine, University of Southern California, 1520 San Pablo Street, Suite 3451, Los Angeles, CA 90033, USA.

出版信息

Anesthesiol Clin. 2019 Mar;37(1):33-50. doi: 10.1016/j.anclin.2018.09.002. Epub 2018 Dec 19.

DOI:10.1016/j.anclin.2018.09.002

PMID:30711232

Abstract

Trauma patients who require intubation are at higher risk for aspiration, agitation/combativeness, distorted anatomy, hemodynamic instability, an unstable cervical spine, and complicated injuries. Although rapid-sequence intubation is the most common technique in trauma, slow-sequence intubation may reduce the risk for failed intubation and cardiovascular collapse. Providers often choose plans with which they are most comfortable. However, developing a flexible team-based approach, through recognition of complicating factors in trauma patients, improves airway management success.

摘要

需要插管的创伤患者发生误吸、躁动/攻击性、解剖结构变形、血流动力学不稳定、颈椎不稳定和复杂损伤的风险更高。尽管快速顺序诱导插管是创伤中最常用的技术，但慢顺序诱导插管可能会降低插管失败和心血管崩溃的风险。医护人员通常会选择他们最熟悉的方案。然而，通过识别创伤患者的复杂因素，制定一种灵活的团队协作方法，可以提高气道管理的成功率。