Pre-Hospital Anesthesia Handbook pp 13-21 | Cite as
Indications and Decision Making
Chapter
First Online:
Abstract
The decision to escalate airway management from basic to advanced is not always clear cut. The primary aim must always be to maintain reliable airway patency and ensure adequate oxygenation and ventilation in order to prevent hypoxia and hypercarbia. The airway is at risk from aspiration or soiling from upper airway debris if the laryngeal reflexes are incompetent or rendered ineffective by drugs. A simple approach may not be the most appropriate as it is labor intensive and unreliable. In these cases, or if clear indications exist, consideration should be given to endotracheal intubation (Boxes 2.1 and 2.2).
Keywords
Laryngeal Mask Airway Adequate Oxygenation Airway Protection Definitive Care Rapid Sequence Intubation
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
References
- Bronchard R, Albaladejo P, Brezac G, Geffroy A, Seine PF (2004) Early onset pneumonia: risk factors and consequences in head trauma patients. Anaesthesiology 100:234–239CrossRefGoogle Scholar
- Davies AE, Kidd D, Stone SP, MacMahon J (1995) Pharyngeal sensation and gag reflex in healthy subjects. Lancet 345:487–488PubMedCrossRefGoogle Scholar
- Hussain LM, Redmond AD (1997) Are pre-hospital deaths from accidental injury preventable? BMJ 79:226–240Google Scholar
- Kluger MT, Short TG (1999) Aspiration during anaesthesia: a review of 133 cases from the Australian Anaesthetic Incident Monitoring study (AIMS). Anaesthesia 54:19–26PubMedCrossRefGoogle Scholar
- Lockey DJ, Coats T, Parr MJA (1999) Aspiration in severe trauma: a prospective study. Anaesthesia 54:1097–1098PubMedCrossRefGoogle Scholar
- McNicholl BP (1994) The golden hour and pre-hospital care. Injury 25:251–254PubMedCrossRefGoogle Scholar
- Ottosson A (1985) Aspiration and obstructed airways as the cause of death in 158 consecutive traffic fatalities. J Trauma 25:538–540PubMedCrossRefGoogle Scholar
- Ufberg JW, Bushra JS, Karras DJ, Satz WA, Kueppers F (2005) Aspiration of gastric contents: association with prehospital intubation. Am J Emerg Med 23:379–382PubMedCrossRefGoogle Scholar
- Vadeboncoeur TF et al (2006) The ability of paramedics to predict aspiration in patients undergoing prehospital rapid sequence intubation. J Emerg Med 30:131–136PubMedCrossRefGoogle Scholar
- Warmer MA, Warmer ME, Weber JG (1993) Clinical significance of pulmonary aspiration during the perioperative period. Anaesthesiology 78:56–62CrossRefGoogle Scholar
- Yates DW (1977) Airway patency in fatal accidents. Br Med J 2:1249–1251PubMedCrossRefGoogle Scholar
Copyright information
© Springer London Limited 2010