Division of Emergency Medicine, Department of Surgery, Larner College of Medicine, University of Vermont, Burlington, Vermont.
Department of Emergency Medicine, Harbor-University of California, Los Angeles Medical Center, Torrance, California.
J Emerg Med. 2020 Oct;59(4):573-585. doi: 10.1016/j.jemermed.2020.05.009. Epub 2020 Jun 23.
Successful airway management is critical to the practice of emergency medicine. Thus, emergency physicians must be ready to optimize and prepare for airway management in critically ill patients with a wide range of physiologic challenges. Challenges in airway management commonly encountered in the emergency department are discussed using a pearl and pitfall discussion in this second part of a 2-part series.
This narrative review presents an evidence-based approach to airway and patient management during endotracheal intubation in challenging cases commonly encountered in the emergency department.
Adverse events during emergent airway management are common with postintubation cardiac arrest, reported in as many as 1 in 25 intubations. Many of these adverse events can be avoided by proper identification and understanding the underlying physiology, preparation, and postintubation management. Those with high-risk features including trauma, elevated intracranial pressure, upper gastrointestinal bleed, cardiac tamponade, aortic stenosis, morbid obesity, and pregnancy must be managed with airway expertise.
This narrative review discusses the pearls and pitfalls of commonly encountered physiologic high-risk intubations with a focus on the emergency clinician.
成功的气道管理是急诊医学实践的关键。因此，急诊医生必须随时准备为各种生理挑战的重症患者优化和准备气道管理。本系列的第 2 部分将使用珍珠和陷阱讨论，讨论在急诊科常见的气道管理挑战。
本叙述性综述介绍了一种基于证据的方法，用于在急诊科常见的具有挑战性的情况下进行气管插管期间的气道和患者管理。
紧急气道管理期间的不良事件很常见，在多达 1/25 的插管中会发生插管后心脏骤停。通过正确识别和理解潜在的生理学、准备和插管后管理，可以避免许多这些不良事件。那些具有高危特征的患者，包括创伤、颅内压升高、上消化道出血、心脏压塞、主动脉瓣狭窄、病态肥胖和妊娠，必须由气道专家进行管理。
本叙述性综述讨论了常见的具有生理挑战性的高危插管的要点和陷阱，重点是急诊临床医生。
