【正文】
人工氣道的建立與管理 Advanced airway management (上) Why are we focus to this…? Patient safety ? 1085 such airway incidents submitted in the two years ( 20xx to 20xx) ? Of the total 1085 incidents ? 200 (%) were associated with tracheal intubation ? 53 (%) with tracheostomy ? 893 (%) were postprocedure problems ? 110 incidents (%) were associated with more than temporary harm ? 88 intubation incidents were associated with equipment problems. ? Partial displacement of tubes resulted in more than temporary harm to the patient (%) Patient safety incidents associated with airway devices in critical care: a review of reports to the UK National Patient Safety Agency. Anaesthesia. 20xx Apr。64(4):3547. 氣道的組成及主要生理意義 ? 口鼻 ? 溫濕、濾過(guò)清潔、共鳴、反射、嗅覺(jué) ? 咽喉 ? 吞咽、呼吸和發(fā)音,調(diào)節(jié)中耳氣壓功能 ? 正常呼吸必經(jīng)之路、發(fā)音器官、溫潤(rùn)作用 氣道的組成及主要生理意義 ? 氣管、支氣管 ?呼吸時(shí)氣管可以擴(kuò)大或縮小 ?氣管在其下端分叉處比較固定,其余部分較易活動(dòng),可隨頭部伸仰、頸部轉(zhuǎn)動(dòng)、吞咽、呼吸等動(dòng)作而變換位置。 氣道管理的適應(yīng)癥 ? 氣道阻塞 ? 窒息 ? 急性創(chuàng)傷昏迷 ? 嚴(yán)重頸部創(chuàng)傷 ? 心肺功能不穩(wěn)定 ? 嚴(yán)重氣管痙攣 ? 嚴(yán)重過(guò)敏性反應(yīng) ? 肺水腫 ? 鎮(zhèn)靜、麻醉藥物的作用 ? 氣道異物 ? 誤吸、存在誤吸危險(xiǎn) ? 非計(jì)劃性拔管 需保持氣道通暢,進(jìn)行有