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心肺复苏期间气道管理的挑战、创新与培训:一项叙述性综述

Challenges, Innovations, and Training in Airway Management During Cardiopulmonary Resuscitation: A Narrative Review.

作者信息

Komasawa Nobuyasu

机构信息

Community Medicine Education Promotion Office, Faculty of Medicine, Kagawa University, Miki, JPN.

出版信息

Cureus. 2024 Oct 17;16(10):e71686. doi: 10.7759/cureus.71686. eCollection 2024 Oct.

Abstract

Emergency airway management is a crucial procedure performed to secure the airway and ensure effective ventilation during respiratory distress or airway obstruction. In the context of cardiopulmonary resuscitation (CPR), this process is complicated by factors such as anatomical challenges, environmental conditions, and the urgency of the situation. Recent advancements in airway management devices, including videolaryngoscopes and supraglottic devices (SGDs), have proven beneficial in managing these challenges. SGDs, such as the laryngeal mask airway (LMA) and i-gel®, provide an effective alternative when tracheal intubation is difficult or when continuous chest compressions are required. Furthermore, simulation-based education plays a critical role in training healthcare providers to handle complex airway scenarios during CPR. This review discusses the challenges of tracheal intubation during CPR, the usefulness of various devices including videolaryngoscopes and gum-elastic bougies (GEB), and the role of simulation training in improving outcomes. Ensuring proficiency in airway management techniques through hands-on practice and advanced simulation is essential for improving both survival rates and neurological outcomes in emergency settings.

摘要

紧急气道管理是一项关键操作,旨在在呼吸窘迫或气道阻塞期间确保气道安全并保证有效通气。在心肺复苏(CPR)的背景下,这一过程因解剖结构复杂、环境条件以及情况紧急等因素而变得复杂。气道管理设备的最新进展,包括视频喉镜和声门上装置(SGD),已证明在应对这些挑战方面具有益处。SGD,如喉罩气道(LMA)和i-gel®,在气管插管困难或需要持续胸外按压时提供了一种有效的替代方法。此外,基于模拟的教育在培训医疗保健人员处理CPR期间复杂气道情况方面发挥着关键作用。本综述讨论了CPR期间气管插管的挑战、包括视频喉镜和弹性橡胶探条(GEB)在内的各种设备的效用,以及模拟培训在改善结果方面的作用。通过实践操作和先进模拟确保气道管理技术的熟练掌握对于提高紧急情况下的生存率和神经功能预后至关重要。

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Supraglottic airway device placement by respiratory therapists.呼吸治疗师行声门上气道装置置入。
Am J Emerg Med. 2018 Oct;36(10):1845-1848. doi: 10.1016/j.ajem.2018.06.030. Epub 2018 Jun 13.

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