Hews J, El-Boghdadly K, Ahmad I
Specialist Registrar, Department of Anaesthesia, Guy's & St Thomas' NHS Foundation Trust, London SE1 9RT.
Consultant Anaesthetist, Department of Anaesthesia, Guy's & St Thomas' NHS Foundation Trust, London.
Br J Hosp Med (Lond). 2019 Aug 2;80(8):432-440. doi: 10.12968/hmed.2019.80.8.432.
This article reviews the key considerations when managing a patient with a difficult airway. The difficult airway may be anticipated from preassessment allowing time for investigations and preparation. Alternatively, the unanticipated difficult airway can present in an emergency situation, or unexpectedly during a routine anaesthetic. The main airway management techniques are discussed with a description of their advantages and limitations. Current guidelines are included that demonstrate how the techniques are incorporated into an overall strategy with a plan A-D when failure occurs. It is critical to progress through such an algorithm in a timely manner to prevent the onset of hypoxia.
本文回顾了处理困难气道患者时的关键注意事项。通过术前评估可能预见困难气道,从而有时间进行检查和准备。另外,意外困难气道可能出现在紧急情况中,或在常规麻醉期间意外出现。文中讨论了主要的气道管理技术,并描述了其优缺点。还纳入了当前指南,展示了这些技术在失败时如何与A-D计划一起纳入整体策略。及时按照这样的流程进行操作以防止缺氧的发生至关重要。