Pre-hospital airway management: guidelines from a task force from the Scandinavian Society for Anaesthesiology and Intensive Care Medicine

被引:101
作者
Berlac, P. [1 ]
Hyldmo, P. K. [2 ]
Kongstad, P.
Kurola, J. [3 ]
Nakstad, A. R. [4 ]
Sandberg, M. [5 ]
机构
[1] Capital Reg Denmark, Rigshosp, Copenhagen Mobile Intens Care Unit, Copenhagen, Denmark
[2] Sorlandet Hosp, Div Anaesthesia & Emergency Med, Kristiansand, Norway
[3] Kuopio Univ Hosp, Dept Anaesthesia & Intens Care, SF-70210 Kuopio, Finland
[4] Ullevaal Univ Hosp, Dept Anaesthesiol, Oslo, Norway
[5] Ullevaal Univ Hosp, Air Ambulance Dept, Lorenskog, Norway
关键词
pre-hospital; airway management; endotracheal intubation; laryngeal mask airway; laryngeal tube airway; combitube; emergency medical systems;
D O I
10.1111/j.1399-6576.2008.01673.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
This article is intended as a generic guide to evidence-based airway management for all categories of pre-hospital personnel. It is based on a review of relevant literature but the majority of the studies have not been performed under realistic, pre-hospital conditions and the recommendations are therefore based on a low level of evidence (D). The advice given depends on the qualifications of the personnel available in a given emergency medical service (EMS). Anaesthetic training and routine in anaesthesia and neuromuscular blockade is necessary for the use of most techniques in the treatment of patients with airway reflexes. For anaesthesiologists, the Task Force commissioned by the Scandinavian Society of Anaesthesia and Intensive Care Medicine recommends endotracheal intubation (ETI) following rapid sequence induction when securing the pre-hospital airway, although repeated unsuccessful intubation attempts should be avoided independent of formal qualifications. Other physicians, as well as paramedics and other EMS personnel, are recommended the lateral trauma recovery position as a basic intervention combined with assisted mask-ventilation in trauma patients. When performing advanced cardiopulmonary resuscitation, we recommend that non-anaesthesiologists primarily use a supraglottic airway device. A supraglottic device such as the laryngeal tube or the intubation laryngeal mask should also be available as a backup device for anaesthesiologists in failed ETI.
引用
收藏
页码:897 / 907
页数:11
相关论文
共 70 条
  • [1] Survey of out-of-hospital emergency intubations in the French prehospital medical system: A multicenter study
    Adnet, F
    Jouriles, NJ
    Le Toumelin, P
    Hennequin, B
    Taillandier, G
    Rayeh, F
    Couvreur, J
    Nougiere, B
    Nadiras, P
    Ladka, A
    Fleury, M
    [J]. ANNALS OF EMERGENCY MEDICINE, 1998, 32 (04) : 454 - 460
  • [2] A COMPARISON OF THE LARYNGEAL MASK AIRWAY AND GUEDEL AIRWAY, BAG AND FACEMASK FOR MANUAL VENTILATION FOLLOWING FORMAL TRAINING
    ALEXANDER, R
    HODGSON, P
    LOMAX, D
    BULLEN, C
    [J]. ANAESTHESIA, 1993, 48 (03) : 231 - 234
  • [3] Effect of the prehospital trauma life support program (PHTLS) on prehospital trauma care
    Ali, J
    Adam, RU
    Gana, TJ
    Bedaysie, H
    Williams, JI
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1997, 42 (05): : 786 - 790
  • [4] The laryngeal tube compared with the laryngeal mask: insertion, gas leak pressure and gastric insufflation
    Asai, T
    Kawashima, A
    Hidaka, I
    Kawachi, S
    [J]. BRITISH JOURNAL OF ANAESTHESIA, 2002, 89 (05) : 729 - 732
  • [5] The position of the spine in the recovery position - an experimental comparison between the lateral recovery position and the modified HAINES position
    Blake, WED
    Stillman, BC
    Eizenberg, N
    Briggs, C
    McMeeken, JM
    [J]. RESUSCITATION, 2002, 53 (03) : 289 - 297
  • [6] Endotracheal intubation in the field does not improve outcome in trauma patients who present without an acutely lethal traumatic brain injury
    Bochicchio, GV
    Ilahi, O
    Joshi, M
    Bochicchio, K
    Scalea, TM
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2003, 54 (02): : 307 - 311
  • [7] New airways for resuscitation?
    Cook, T. M.
    Hommers, C.
    [J]. RESUSCITATION, 2006, 69 (03) : 371 - 387
  • [8] Randomized crossover comparison of the ProSeal™ laryngeal mask airway with the Laryngeal Tube® during anaesthesia with controlled ventilation
    Cook, TM
    McKinstry, C
    Hardy, R
    Twigg, S
    [J]. BRITISH JOURNAL OF ANAESTHESIA, 2003, 91 (05) : 678 - 683
  • [9] Cook TM, 2003, ANAESTHESIA, V58, P191
  • [10] An evaluation of the airway management device
    Cook, TM
    Gupta, K
    Gabbott, DA
    Nolan, JP
    [J]. ANAESTHESIA, 2001, 56 (07) : 660 - 664