[Mask ventilation as an exit strategy of endotracheal intubation].
The goal of ventilation in an unprotected airway is to optimize oxygenation and carbon dioxide elimination of the patient. This can be achieved with techniques such as mouth-to-mouth ventilation, but preferably with bag-valve-mask ventilation. Securing the airway with an endotracheal tube is the gold standard, but excellent success in emergency airway management depends on initial training, retraining, and actual frequency of a given procedure in the routine. "Patients do not die from failure to intubate; they die from failure to stop trying to intubate or from undiagnosed oesophageal intubation" (Scott 1986). Therefore, adequate face mask ventilation has absolute priority in airway management by an unexperienced rescuer. During ventilation of an unprotected airway, stomach inflation and subsequent severe complications may result. Careful ventilation can be performed with low inspiratory pressure and flow, and subsequently with a low tidal volume at a high inspiratory fraction of oxygen. This could be a strategy to achieve more patient safety.
von Goedecke
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A
Univ.-Klinik für Anaesthesie und Allgemeine Intensivmedizin, Medizinische Universität, Innsbruck, Osterreich. achim.von-goedecke@uibk.ac.at
Keller
C
C
Voelckel
W G
WG
Dünser
M
M
Paal
P
P
Torgersen
C
C
Wenzel
V
V
D000293:Adolescent; D000328:Adult; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services; D015600:Glasgow Coma Scale; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000628:therapy; D010102:Oxygen Inhalation Therapy; D011859:Radiography; D012121:Respiration, Artificial