King H K, Wang L F, Khan A K, Wooten D J
Crit Care Med. 1987 Sep;15(9):869-71. doi: 10.1097/00003246-198709000-00014.
Airway obstruction remains a constant problem in acute care. This is particularly true when there are anatomical or pathological abnormalities, trauma, or when repeated failed attempts at endoscopic or blind intubations have left a bloody field, preventing clear visualization of the vocal cords. Our refinement of translaryngeal guided intubation (TLI) uses a spring guidewire accompanied by a plastic sheath protector. The wire is introduced percutaneously via a cricothyroid puncture and passed cephalad into the oropharynx or nasopharynx and out through the mouth or one of the nostrils. The plastic sheath is slid over the wire into the trachea. A well-lubricated endotracheal tube is then inserted to the desired position using the plastic sheath as a stylet. This technique works very well, and we are convinced that TLI is one of the most effective emergency techniques to secure an airway. It can be performed quickly with inexpensive equipment and is a promising addition to the currently recommended alternatives.
气道梗阻在急性护理中仍然是一个持续存在的问题。当存在解剖学或病理学异常、创伤时，或者在内镜插管或盲目插管反复失败后出现出血情况，导致无法清晰看到声带时，情况尤其如此。我们改进的经喉引导插管（TLI）使用带有塑料护套保护器的弹簧导丝。导丝经皮通过环甲膜穿刺插入，然后向头端进入口咽或鼻咽，并从口腔或一个鼻孔穿出。将塑料护套顺着导丝滑入气管。然后使用塑料护套作为管芯，将润滑良好的气管内导管插入到所需位置。这项技术效果很好，我们确信TLI是确保气道安全的最有效的紧急技术之一。它可以使用廉价设备快速完成，是目前推荐的替代方法中一个很有前景的补充技术。
