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Methoden des Atemwegsmanagements in der präklinischen Notfallmedizin

Methods of airway management in prehospital emergency medicine

  • Notfallmedizin
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Zusammenfassung

In den meisten Fällen gelingt es in Notfallsituationen, mit oder ohne vorangehender Maskenbeatmung, durch die endotracheale Intubation eine definitive Atemwegskontrolle zu erzielen. Maskenbeatmung und endotracheale Intubation können jedoch aufgrund vielfältiger Ursachen scheitern. Daher müssen sowohl für Routine- als auch für Notfallsituationen alternative Methoden zur Sicherung der Atemwege und zur Beatmung vorgehalten werden. Die vorliegende Übersicht weist auf mögliche Probleme im Rahmen des konventionellen Atemwegsmanagements hin und gibt einen Überblick über die aktuell verfügbaren Alternativen.

Abstract

In the majority of emergency situations definite airway control can be achieved by endotracheal intubation with or without preceding bag valve mask ventilation. However, both techniques can fail because of many different reasons. Therefore, alternative techniques for routine anaesthesia and emergency situations are required. In the present article difficulties that may arise using bag valve mask ventilation and endotracheal intubation are discussed and an overview of available alternatives is given.

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Danksagung

Die in dieser Publikation enthaltenen anatomischen Abbildungen wurden in Kooperation mit dem Anatomischen Institut II des Universitätsklinikums Heidelberg erstellt.

Für die Bereitstellung der Punktionssets bzw. der supraglottischen Atemhilfen bedanken wir uns herzlich bei den Firmen VBM Medizintechnik, Cook Deutschland GmbH, Tyco Healthcare Deutschland GmbH, Medi-King GmbH und LMA Vertriebs GmbH. Den Kollegen der Anästhesieabteilung des Kreiskrankenhaus Bergstraße danken wir für die praktische Unterweisung im Umgang mit dem Bullard-Laryngosop, Herrn Prof. Dr. med. E. Zadrobilek für seine praktischen Ratschläge. Herrn Dr. med. Moritz Wente, Frau Dr. med. Kathrin Degenhardt und Frau Kathrin Radeck danken wir für die kritische Durchsicht des Manuskripts.

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  1. Klinik für Anaesthesiologie, Bereich Notfallmedizin, Ruprecht-Karls-Universität, Heidelberg

    W. Keul, M. Bernhard, R. Gust & A. Gries

  2. Anatomisches Institut II, Ruprecht-Karls-Universität, Heidelberg

    A. Völkl

  3. Deutsche Rettungsflugwacht, Luftrettungszentrum „Christoph 53“, Mannheim

    A. Gries

  4. Klinik für Anaesthesiologie, Bereich Notfallmedizin, Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg

    W. Keul

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  1. W. Keul
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Keul, W., Bernhard, M., Völkl, A. et al. Methoden des Atemwegsmanagements in der präklinischen Notfallmedizin. Anaesthesist 53, 978–992 (2004). https://doi.org/10.1007/s00101-004-0734-9

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