Zusammenfassung
Die Atemwegssicherung stellt eine zentrale Maßnahme in der Notfall- und Intensivmedizin dar, um jederzeit eine ausreichende Oxygenierung zu gewährleisten. Aufgrund des meist kritischen Patientenzustandes, der oft eingeschränkten Umgebungsbedingungen und oft auch unzureichender Erfahrung aller Beteiligten ist sie sehr risikobehaftet. Oberstes Ziel ist deshalb die Umgehung einer Intubation durch konsequente Anwendung nichtinvasiver Beatmung gerade auch im präklinischen Bereich. Bei bestehender Notwendigkeit zur Intubation müssen ausreichende Rückfallebenen bzw. Alternativkonzepte zur Beherrschung des möglicherweise schwierigen Atemweges vorhanden sein. Als moderne, unterstützende Verfahren stehen hier die fiberoptische Wachintubation und Videolaryngoskope zur Verfügung, mit denen die Sicherheit und Erfolgsrate deutlich verbessert werden können. Aufgrund der ubiquitären Anwendbarkeit erscheint der Routineeinsatz der Videolaryngoskopie in der Notfall- und Intensivmedizin empfehlenswert.
Abstract
A secured airway is of utmost importance in emergency and intensive care medicine to ensure sufficient oxygenation. In emergency and intensive care medicine, patients are usually considered to be in a life-threatening condition, environmental aspects are far from optimal, and the personal experience of all participants is often limited; thus, any attempt to intubate such patients has to be considered a failure-prone intervention. Therefore, one of the major goals should be the complete avoidance of endotracheal intubation, e.g., via noninvasive ventilation. If intubation is inevitable, it is crucial to plan alternative strategies in case of difficulties or failure. Fiberoptic intubation in alert patients and videolaryngoscopy have proven their effectiveness to decrease the risk of airway difficulties in acute and critically ill patients. Since availability and utility of videolaryngoscopy is not restricted technically, we strongly recommend its use in emergency and intensive care medicine.
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Kill, C., Kratz, T. Schwieriger Atemweg in der Notfall- und Intensivmedizin. Intensivmed 47, 530–538 (2010). https://doi.org/10.1007/s00390-010-0165-6
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DOI: https://doi.org/10.1007/s00390-010-0165-6