Salvino C K, Dries D, Gamelli R, Murphy-Macabobby M, Marshall W
Loyola University Medical Center, Maywood, IL 60153.
J Trauma. 1993 Apr;34(4):503-5. doi: 10.1097/00005373-199304000-00006.
The first dictum of trauma care is to establish an airway. Infrequently endotracheal intubation is unsuccessful or contraindicated, and a surgical airway is required. We reviewed 30 emergency cricothyroidotomies among 8320 admissions over a 36-month period at a level I trauma center. Twenty cricothyroidotomies were performed in the emergency room by Trauma Service personnel and 10 during prehospital care by flight nurses. Cricothyroidotomy was the first airway control maneuver performed in 7 patients and 23 cricothyroidotomies were performed after attempts at oral intubation failed. No major complications were identified. Minor complications identified in the hospital included minimal subglottic stenosis (2), local wound infection (1), and nonthreatening hemorrhage (1). Fifteen patients were long-term survivors. We conclude that emergency cricothyroidotomy is a safe and rapid means of obtaining an airway when endotracheal intubation fails or is contraindicated.
创伤救治的首要原则是建立气道。气管内插管偶尔会不成功或存在禁忌，此时需要建立外科气道。我们回顾了在一家一级创伤中心36个月期间8320例入院患者中的30例紧急环甲膜切开术。20例环甲膜切开术由创伤服务人员在急诊室进行，10例由飞行护士在院前护理期间进行。环甲膜切开术是7例患者进行的首次气道控制操作，23例环甲膜切开术是在经口插管尝试失败后进行的。未发现重大并发症。在医院发现的轻微并发症包括轻度声门下狭窄（2例）、局部伤口感染（1例）和无威胁性出血（1例）。15例患者为长期存活者。我们得出结论，当气管内插管失败或存在禁忌时，紧急环甲膜切开术是一种安全、快速的建立气道的方法。
