Maxillofacial trauma patient: Coping with the difficult airway

被引：20

作者：

Krausz A.A. ^{[1
]}

El-Naaj I.A. ^{[1
]}

Barak M. ^{[2
]}

机构：

[1] Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa

[2] Department of Anesthesiology, Rambam Health Care Campus, Bruce Rappaport Faculty of Medicine, Haifa

来源：

World Journal of Emergency Surgery | / 4卷 / 1期

关键词：

Vocal Cord; Airway Management; Laryngeal Mask Airway; Difficult Airway; Direct Laryngoscopy;

D O I：

10.1186/1749-7922-4-21

中图分类号：

学科分类号：

摘要：

Establishing a secure airway in a trauma patient is one of the primary essentials of treatment. Any flaw in airway management may lead to grave morbidity and mortality. Maxillofacial trauma presents a complex problem with regard to the patient's airway. By definition, the injury compromises the patient's airway and it is, therefore, must be protected. In most cases, the patient undergoes surgery for maxillofacial trauma or for other, more severe, life-threatening injuries, and securing the airway is the first step in the introduction of general anaesthesia. In such patients, we anticipate difficult endotracheal intubation and, often, also difficult mask ventilation. In addition, the patient is usually regarded as having a "full stomach" and has not been cleared of a C-spine injury, which may complicate airway management furthermore. The time available to accomplish the task is short and the patient's condition may deteriorate rapidly. Both decision-making and performance are impaired in such circumstances. In this review, we discuss the complexity of the situation and present a treatment approach. © 2009 Krausz et al; licensee BioMed Central Ltd.

引用

共 33 条

[1]

Advanced Trauma Life Support for Doctors ATLS, (2004)

[2]

Walls R.M., Management of the difficult airway in the trauma patient, Emerg Med Clin North Am, 16, pp. 45-61, (1998)

[3]

Domino K.B., Posner K.L., Caplan R.A., Cheney F.W., Airway injury during anesthesia: A closed claims analysis, Anesthesiology, 91, pp. 1703-1711, (1999)

[4]

Peterson G.N., Domino K.B., Caplan R.A., Posner K.L., Lee L.A., Cheney F.W., Management of the difficult airway: A closed claims analysis, Anesthesiology, 103, pp. 33-39, (2005)

[5]

Garcia A., Critical care issues in the early management of severe trauma, Surg Clin North Am, 86, pp. 1359-1387, (2006)

[6]

Gruen R.L., Jurkovich G.J., McIntyre L.K., Foy H.M., Maier R.V., Patterns of errors contributing to trauma mortality: Lessons learned from 2,594 deaths, Ann Surg, 244, pp. 371-380, (2006)

[7]

Hutchison I., Lawlor M., Skinner D., ABC of major trauma. Major maxillofacial injuries, BMJ, 301, pp. 595-599, (1990)

[8]

Crosby E.T., Airway management in adults after cervical spine trauma, Anesthesiology, 104, pp. 1293-1318, (2006)

[9]

Manoach S., Paladino L., Manual in-line stabilization for acute airway management of suspected cervical spine injury: Historical review and current questions, Ann Emerg Med, 50, pp. 236-245, (2007)

[10]

Santoni B.G., Hindman B.J., Puttlitz C.M., Weeks J.B., Johnson N., Maktabi M.A., Todd M.M., Manual in-line stabilization increases pressures applied by the laryngoscope blade during direct laryngoscopy and orotracheal intubation, Anesthesiology, 110, pp. 24-31, (2009)

← 1 2 3 4 →