ISSN: 1451-124X
Strana: 191-203
Rezime: Indikacije za endotrahealnu intubaciju u urgentnoj medicini su respiratorni ili kardijalni zastoj ili insuficijencija, kao i teške politraume, spoljašnja ili unutrašnja krvavljenja sa gubitkom krvi od preko 20% cirkulatornog volumena, što podrazumeva brzo i neodložno intubiranje na mestu nesreće. Bernoulli, (1996) kaže: “Endotrahealna intubacija je “zlatan standard” obezbeđivanja disajnog puta. široko prihvaćen u celom svetu pa i kod nas. Metoda je sveobuhvatno opisana počev od indikacija i kontraindikacija, tehnike izvođenja, tehničkih teškoća, pribora i opreme. Cilj ovog rada takođe je bio da se ukaže na moguće uzroke otežane intubacije i preporuče načini njihovog mogućeg prevazilaženja. U radu su detaljno opisane sve do danas opisane tehnike endotrahealne intubacije kod teškog obezbeđivanja disajnog puta. Zbog teškoća u izvođenju klasične endotrahealne intubacije osmišljavana su alternativna sredstva za održavanje vazdušnog puta. To su: ezofagealni opturatorni airway, ezofagealni tubus (kombitubus), laringealna maska i orofaringealni tubus sa balončićem.
Ključne reči: Endotrahealna intubacija, otežana intubacija, održavanje disajnog puta, alternativna sredstva
OUT-OF-HOSPITAL URGENT ENDOTRACHEAL INTUBATION
Abstract: Indications for endotracheal intubation in emergency medicine are respiratory or cardiac arrest or insufficiency as well as severe polytrauma, external or internal bleeding with blood loss over 20% of circulatory volume, requiring urgent intubation at the accident site. In 1996 Bernoulli wrote that endotracheal intubation was the “golden standard” in airway management and it had been widely accepted in the world and in our country. This method has been described in detail, as well as indications, contraindications, techniques, difficulties, nece-ssary equipment and so on. The aim of this study was also to point to possible causes of difficult intubation and to imply modalities to prevail them. It also describes all techniques of endotracheal intubation being used today in cases of difficult airway management. Due to difficulties in performing classic endotracheal intubation, alternative airway management procedures have been developed. These procedures are as follows: esophageal obturating airway, esophageal tube, laryngeal mask and oropharyneal tube with a balloon.
Key words: Endotracheal intubation, difficult intubation, Airway management, Alternative means
Ključne reči: Endotrahealna intubacija, otežana intubacija, održavanje disajnog puta, alternativna sredstva
OUT-OF-HOSPITAL URGENT ENDOTRACHEAL INTUBATION
Abstract: Indications for endotracheal intubation in emergency medicine are respiratory or cardiac arrest or insufficiency as well as severe polytrauma, external or internal bleeding with blood loss over 20% of circulatory volume, requiring urgent intubation at the accident site. In 1996 Bernoulli wrote that endotracheal intubation was the “golden standard” in airway management and it had been widely accepted in the world and in our country. This method has been described in detail, as well as indications, contraindications, techniques, difficulties, nece-ssary equipment and so on. The aim of this study was also to point to possible causes of difficult intubation and to imply modalities to prevail them. It also describes all techniques of endotracheal intubation being used today in cases of difficult airway management. Due to difficulties in performing classic endotracheal intubation, alternative airway management procedures have been developed. These procedures are as follows: esophageal obturating airway, esophageal tube, laryngeal mask and oropharyneal tube with a balloon.
Key words: Endotracheal intubation, difficult intubation, Airway management, Alternative means
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