Complex intubation, cricothyrotomy and tracheotomy

作者：Leach R; Idrissi S Hachimi; Meulemans J; Monsieurs K; Vanderveken O; Vander Poorten V

来源：B-ENT, 2016, 12: 103-118.

• Emergency
• airway management
• cricothyrotomy
• surgical airway
• cannot intubate cannot ventilate
• tracheostomy
• percutaneous

Successful management of a difficult airway begins with recognizing the potential problem. When the patient cannot breathe spontaneously, oxygenation and ventilation should start first with bag-valve ventilation, with or without an airway adjunct such as a Mayo cannula, followed by an orotracheal intubation attempt, performed by an experienced emergency doctor. If orotracheal intubation fails, a quick decision must be made regarding surgical options. In a "cannot intubate, cannot ventilate" situation, a surgical cricothyrotomy should be considered. When orotracheal intubation is impossible, but bag-valve or laryngeal mask ventilation is possible, an urgent surgical tracheostomy should be performed. In the long run, patients in need of long-term artificial ventilation will need a percutaneous or open tracheostomy. This review provides an update of all aspects of immediate and long-term airway management.

• 出版日期2016