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Notfall + Rettungsmedizin

10.06.2016 | Übersicht

First-Pass Intubation Success

Bedeutung und Umsetzung in der Notfallmedizin

verfasst von: Priv.-Doz. Dr. med J. Knapp, V. Wenzel, R. Greif, B. Hossfeld, M. Bernhard

Erschienen in: Notfall + Rettungsmedizin

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Zusammenfassung

Hintergrund

Das Atemwegsmanagement ist eine der zentralen Aufgaben eines jeden notfallmedizinisch tätigen Arztes. Die prähospitale endotracheale Intubation stellt sich dabei im Vergleich zur innerklinischen Situation oft als schwieriger und komplikationsreicher dar.

Methode

Anhand der vorliegenden Literatur soll die Bedeutung einer erfolgreichen endotrachealen Intubation im ersten Versuch (sog. First-Pass Intubation Success, FPS) und der Möglichkeiten dessen Optimierung in der Notfallmedizin dargestellt und diskutiert werden.

Ergebnisse

Zahlreiche Studien zeigen, dass bei 2 oder mehr Intubationsversuchen die Rate an Komplikationen (wie z. B. Hypoxie, Aspiration, Herzkreislaufstillstand) um den Faktor 4 bis 7 ansteigt. Die vorliegende Literatur macht deutlich, dass eine wesentliche Voraussetzung für einen möglichst hohen FPS und damit eine hohe Patientensicherheit insbesondere eine gute Ausbildung und regelmäßiges Training in der endotrachealen Intubation ist. Eine Narkoseeinleitung sollte standardisiert und nach sorgsamer Präoxygenierung erfolgen. Die Bedeutung des Einsatzes von Muskelrelaxanzien und der Videolaryngoskopie für den FPS steht zur Diskussion.
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Metadaten
Titel
First-Pass Intubation Success
Bedeutung und Umsetzung in der Notfallmedizin
verfasst von
Priv.-Doz. Dr. med J. Knapp
V. Wenzel
R. Greif
B. Hossfeld
M. Bernhard
Publikationsdatum
10.06.2016
Verlag
Springer Medizin
Erschienen in
Notfall + Rettungsmedizin
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-016-0168-3