White R D
Ann Emerg Med. 1984 Sep;13(9 Pt 2):778-81. doi: 10.1016/s0196-0644(84)80434-5.
Maintaining an unobstructed airway and providing adequate oxygenation and CO2 elimination, by artificial means if necessary, are among the highest priorities in all life-threatening circumstances. How this goal can best be met in the prehospital setting has become a controversial issue. The esophageal obturator airway (EOA) frequently is used in the prehospital setting, but its use and effectiveness recently have been criticized. A critical review of available literature reveals two areas of concern: 1) many clinical studies do not address prehospital airway management, and 2) the EOA has only one advantage over mask techniques for artificial ventilation, ie, it reduces the likelihood of aspiration of gastric contents. This advantage was the only one postulated by initial investigators. Many perceived EOA problems are due to poor mask fit and can be rectified. Although endotracheal intubation is the accepted standard for airway management in the apneic patient, its limitations in the prehospital setting are many. These utilization problems and complications remain undefined and must be addressed.
保持气道通畅，并在必要时通过人工手段提供充足的氧合及二氧化碳排出，这在所有危及生命的情况下都是最优先考虑的事项之一。在院前环境中如何最好地实现这一目标已成为一个有争议的问题。食管阻塞气道（EOA）在院前环境中经常被使用，但最近其使用及有效性受到了批评。对现有文献的批判性回顾揭示了两个令人担忧的方面：1）许多临床研究并未涉及院前气道管理，以及2）与面罩人工通气技术相比，EOA仅具有一个优势，即它降低了胃内容物误吸的可能性。这一优势是最初的研究者所假定的唯一优势。许多被认为是EOA的问题是由于面罩贴合不佳导致的，并且可以得到纠正。尽管气管插管是呼吸暂停患者气道管理的公认标准，但其在院前环境中的局限性众多。这些使用问题及并发症仍不明确，必须加以解决。
