Better tools to obtain a patent airway in trauma patients saves lives
Videolaryngoscopy - the intubation technique of the future!
One of the most crucial things an anesthesiologist is faced with during operative interventions and trauma care is to provide a patent airway. Semi-comatose or comatose patients often show obstruction of the glottic inlet by a relaxed tongue. Simple measures can be taken to obtain a patent airway, i.e. chin lift, jaw thrust or a mayo tube1. Nevertheless the act of providing a de nitive airway is to put an airway tube in between the vocal cords to enter the trachea of the patient. In order to be able to visualize the entrance of the trachea windpipe), a special adjunct, the laryngoscope, is used to make insertion of the tube (intubation) easy and effective. However visualization of the vocal cords and intubation of the trachea is not always easy. Indeed, the dif cult airway is the single most important cause of intubation related morbidity and mortality. Especially during induction of surgical anesthesia and in trauma care (e.g. in the military) one has not to lose time. Patients die if a patent airway is not provided for as soon as possible. Both morbidity and mortality increase in emergency and trauma situations, but also when patients
are presented with the likelihood of a dif cult intubation. The rst and urgent priority in trauma care is therefore to provide an open airway. Of the tens of millions of patients undergoing general anesthesia worldwide, a large proportion (90%) of those undergoing tracheal intubation are performed using a traditional laryngoscope with a battery in the handle and a small light bulb near the tip of the blade. In about 10% of the patients fexible fiberoptic intubation is used.
Quelle: MEDICAL CORPS INTERNATIONAL FORUM (MCIF) 2009/3