Zusammenfassung
Hintergrund
Oxygenierung und Ventilation sowie der Schutz vor Aspiration haben für Notfallpatienten eine hohe Priorität. Die präklinischen Verhältnisse sind jedoch mit denen der klinischen Anästhesie nicht vergleichbar. Spezifische Daten über die Häufigkeit von potenziell lebensbedrohlichen Komplikationen und weniger gravierenden unerwünschten Ereignissen im Rahmen der Sicherung der Atemwege durch Notärzte liegen bisher nicht vor.
Material und Methoden
In einer prospektiven Untersuchung wurden in einem Zeitraum von 36 Monaten alle—überwiegend durch Notärzte—getroffenen Maßnahmen zur präklinischen Sicherung der Atemwege mit ihren Auswirkungen auf die Patienten erfasst.
Ergebnisse
Insgesamt konnten 598 Patienten in die Studie eingeschlossen werden; bei allen wurden die Atemwege erfolgreich gesichert. In bis zu 3 Versuchen wurden 98,5% der Patienten orotracheal intubiert, bei 84,6% war lediglich 1 Intubationsversuch erforderlich, 9 Patienten bedurften eines anderen Verfahrens der präklinischen Sicherung der Atemwege, wie des Kombitubus. Über 80% der Maßnahmen verliefen ohne Komplikationen oder unerwünschte Ereignisse, potenziell lebensbedrohliche Komplikationen traten mit insgesamt 9% selten auf.
Schlussfolgerung
Erfolgt die präklinische Sicherung der Atemwege durch in der Sicherung der Atemwege qualifizierte Notärzte, ist mit geringer Komplikations- und hohen Erfolgsrate zu rechnen.
Abstract
Background
Oxygenation and ventilation as well as prevention of aspiration are of vital importance for emergency patients. Prehospital airway management is not comparable to clinical anaesthesia. However, prehospital data of the occurrence of potential life-threatening complications and less severe adverse events of airway management procedures by emergency physicians are not yet available.
Methods
All airway management procedures predominantly performed by emergency physicians over a period of 36 months were recorded prospectively.
Results
Data of 598 consecutive patients were collected, in all patients prehospital airway management could be accomplished successfully. Of the patients 98.5% were successfully intubated endotracheally with a maximum of 3 attempts, 84.6% of patients were intubated at the first attempt, and in 9 patients other techniques such as the Combitube were required. In more than 80% of procedures, no complications or adverse events were recorded and potentially life-threatening complications occurred in 9% of patients only.
Conclusions
Prehospital airway management by emergency physicians experienced in anaesthesia is associated with low complication and high success rates.
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Die Arbeit enthält Teile der Inaugural-Dissertation von Herrn S. Küster an der Johannes Gutenberg-Universität Mainz.
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Thierbach, A., Piepho, T., Wolcke, B. et al. Präklinische Sicherung der Atemwege. Anaesthesist 53, 543–550 (2004). https://doi.org/10.1007/s00101-004-0679-z
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DOI: https://doi.org/10.1007/s00101-004-0679-z