Airway management in the adult prehospital medicine – to tube or not to tube?

Czech version

Authors: O. Klementová ¹; T. Henlín ^2,3; M. Szkorupa ⁴; P. Michálek ^5,6
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice, Olomouc ¹; Klinika anesteziologie, resuscitace a intenzivní medicíny, Vojenská fakultní nemocnice, Praha ²; Odbor letecké záchranné služby a urgentní medicíny AČR Líně, Plzeň ³; 1. chirurgická klinika, Fakultní nemocnice, Olomouc ⁴; Klinika anesteziologie, resuscitace a intenzivní medicíny, 1. LF UK a Všeobecná fakultní nemocnice, Praha ⁵; Department of Anaesthesia and Intensive Medicine, Antrim Area Hospital, Antrim, Spojené království ⁶
Published in: Anest. intenziv. Med., 31, 2020, č. 1-2, s. 6-12
Category: Review Articles

Overview

Adequate oxygenation and maintaining the patent airway are one of the key factors for patient survival in prehospital care. The main difference against the operating room is the environment of the accident and experience with the qualification of the provider. Basic techniques include the use of manual maneuvers for opening the airway, bag-mask ventilation, and insertion of the oropharyngeal or nasopharyngeal airways. Advanced techniques involve the insertion of a supraglottic airway device and tracheal intubation. Surgical cricothyrotomy is indicated only in a small number of patients and in the battlefield medicine. Tracheal intubation still remains a method of choice when performed by experience provider, for the unconscious victims and resuscitation in out-of-hospital cardiac arrest. Special tools such as gum elastic bougie or videolaryngoscopes are employed to increase the success rate of out of hospital tracheal intubation. Supraglottic airway devices inserted in prehospital care include laryngeal mask airways, i-gel, and laryngeal tube.

Keywords:

tracheal intubation – supraglottic airway device – cricothyrotomy – prehospital care

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