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院前心脏骤停气道管理:NAEMSP 立场声明和资源文件。

Prehospital Cardiac Arrest Airway Management: An NAEMSP Position Statement and Resource Document.

出版信息

Prehosp Emerg Care. 2022;26(sup1):54-63. doi: 10.1080/10903127.2021.1971349.

Abstract

Airway management is a critical component of out-of-hospital cardiac arrest (OHCA) resuscitation. Multiple cardiac arrest airway management techniques are available to EMS clinicians including bag-valve-mask (BVM) ventilation, supraglottic airways (SGAs), and endotracheal intubation (ETI). Important goals include achieving optimal oxygenation and ventilation while minimizing negative effects on physiology and interference with other resuscitation interventions. NAEMSP recommends:Based on the skill of the clinician and available resources, BVM, SGA, or ETI may be considered as airway management strategies in OHCA.Airway management should not interfere with other key resuscitation interventions such as high-quality chest compressions, rapid defibrillation, and treatment of reversible causes of the cardiac arrest.EMS clinicians should take measures to avoid hyperventilation during cardiac arrest resuscitation.Where available for clinician use, capnography should be used to guide ventilation and chest compressions, confirm and monitor advanced airway placement, identify return of spontaneous circulation (ROSC), and assist in the decision to terminate resuscitation.

摘要

气道管理是院外心脏骤停(OHCA)复苏的一个关键组成部分。急救医疗服务(EMS)临床医生可使用多种心脏骤停气道管理技术,包括球囊-面罩通气(BVM)、声门上气道(SGA)和气管内插管(ETI)。重要目标包括在尽量减少对生理的负面影响和不干扰其他复苏干预的情况下,实现最佳的氧合和通气。NAEMSP 建议:根据临床医生的技能和可用资源,可以考虑 BVM、SGA 或 ETI 作为 OHCA 的气道管理策略。气道管理不应干扰其他关键复苏干预措施,如高质量的胸外按压、快速除颤和治疗心脏骤停的可逆原因。EMS 临床医生应采取措施避免在心脏骤停复苏期间过度通气。在临床医生可用的情况下,应使用呼气末二氧化碳监测来指导通气和胸外按压,确认和监测高级气道的放置,识别自主循环恢复(ROSC),并协助决定终止复苏。

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