Froehlich Mary, McNickle Allison G, Fraser Douglas R
Department of Surgery, Kirk Kerkorian School of Medicine at UNLV, 1701 W. Charleston Blvd., Suite 490, Las Vegas, NV 89102, United States.
Surg Pract Sci. 2022 Aug 2;10:100118. doi: 10.1016/j.sipas.2022.100118. eCollection 2022 Sep.
This study characterizes the prehospital and trauma bay airway management of self-inflicted gunshot wounds (SI-GSWs) to the face.
We reviewed SI-GSWs to the face from 2017 to 2021. Patients with isolated temporal GSWs were excluded. Emergency Medical Services (EMS) and trauma bay information on airway management were collected.
38 patients presented with a SI-GSW to the face. 20 of the 29 transported by EMS were managed without advanced airways. There were four endotracheal intubations, three supraglottic airways, and two failed intubations. Those with advanced airways had lower GCS (3 vs. 15, <0.01) and systolic blood pressure (94 vs. 144, <0.01). After hospital arrival, 22 SI-GSWs were endotracheally intubated in the trauma bay and two in the OR. No cricothyroidotomies were performed.
A majority of SI-GSWs to the face can be managed by EMS using noninvasive support. Supraglottic airways may be an option for those requiring invasive support.
本研究描述了面部自伤性枪伤（SI-GSWs）的院前和创伤室气道管理情况。
我们回顾了2017年至2021年的面部SI-GSWs病例。排除单纯颞部枪伤患者。收集了紧急医疗服务（EMS）和创伤室关于气道管理的信息。
38例患者表现为面部SI-GSWs。29例由EMS转运的患者中，20例在未使用高级气道的情况下得到处理。有4例进行了气管插管，3例使用了声门上气道，2例插管失败。使用高级气道的患者格拉斯哥昏迷评分（GCS）较低（3分对15分，<0.01），收缩压也较低（94对144，<0.01）。入院后，22例SI-GSWs患者在创伤室进行了气管插管，2例在手术室进行了气管插管。未进行环甲膜切开术。
大多数面部SI-GSWs患者可由EMS使用无创支持进行处理。对于需要有创支持的患者，声门上气道可能是一种选择。
