Prehosp Emerg Care. 2020 Jul-Aug;24(4):590-594. doi: 10.1080/10903127.2019.1671565. Epub 2019 Oct 14.
A 26-year-old female patient presented in cardiac arrest from presumed opioid overdose. An Ambu King LTS-D laryngeal device was placed by EMS providers for airway management during the resuscitation. There was no documented difficulty with placement and breath sounds and waveform capnography were consistent with appropriate placement. The resuscitation was terminated on scene after extensive resuscitative efforts by the EMS crew. Upon autopsy of the patient, it was discovered that the laryngeal tube device had caused a deep 5 cm perforation to the left piriform recess. The laryngeal tube had bent and was pushed into the perforation in the piriform recess; had the patient had regain of spontaneous circulation this could have caused significant morbidity. Laryngeal tube airway devices have shown increased usage in healthcare settings, in particular in the prehospital arena. Studies of these airway devices have shown they have quick insertion times, high success rates, and low complications. Tongue swelling and minor trauma are common complications of laryngeal tube airway devices. The case report describes a rare, yet potentially life-threatening, complication of laryngeal tube airway device placement- hypopharyngeal injury. If unrecognized, this injury could lead to serious complications. Providers should be aware of the common and uncommon injuries that are associated with prehospital laryngeal tube airway device placement.
一位 26 岁女性患者因疑似阿片类药物过量而心脏骤停。在复苏过程中，EMS 提供者使用 Ambu King LTS-D 喉罩设备进行气道管理。放置过程中没有记录到困难，呼吸音和波形二氧化碳描记法与适当的放置一致。经过 EMS 工作人员的广泛复苏努力，现场复苏终止。在对患者进行尸检时，发现喉管设备在左侧梨状窝造成了深达 5 厘米的穿孔。喉管弯曲并被推入梨状窝的穿孔中；如果患者恢复自主循环，这可能会导致严重的发病率。喉管气道设备在医疗保健环境中的使用有所增加，特别是在院前领域。这些气道设备的研究表明，它们具有快速插入时间、高成功率和低并发症。舌肿胀和轻微创伤是喉管气道设备的常见并发症。该病例报告描述了喉管气道设备放置中一种罕见但潜在危及生命的并发症——下咽损伤。如果未被识别，这种损伤可能会导致严重的并发症。提供者应了解与院前喉管气道设备放置相关的常见和不常见的损伤。
