Videolaryngoskopie im Notfall sinnvoll einsetzen

Zusammenfassung

Die Bedeutung eines erfolgreichen ersten Intubationsversuchs in der Atemwegssicherung ist in mehreren Studien belegt. Zum Gelingen können neben einer guten Ausbildung und regelmäßigem Training vor allem ein standardisiertes Vorgehen im Team mit ausgiebiger Präoxygenierung und optimaler Lagerung des Patienten sowie eine ausreichend tiefe Narkose mit Verwendung von Muskelrelaxanzien und schließlich der Einsatz eines Videolaryngoskops bereits mit dem ersten Intubationsversuch beitragen. Dieser Artikel beschreibt die Möglichkeiten der Videolaryngoskopie in der prähospitalen Notfallmedizin.

Abstract

The importance of a successful first attempt in endotracheal intubation is demonstrated in several studies. In addition to excellent training and routined skills of the performers, a standardized procedure in the team with extensive preoxygenation and optimal patient positioning as well as a sufficiently deep anesthesia including muscle relaxation, and finally the use of a videolaryngoscope with the first attempt may contribute to a high first-pass success. This article describes the possibilities of videolaryngoscopy in out-of-hospital emergency medicine.

Kernaussagen

• Die Bedeutung eines erfolgreichen ersten Intubationsversuchs in der Atemwegssicherung wurde in mehreren Studien belegt.

• Zu einem erfolgreichen ersten Intubationsversuch tragen bei:

  • gute Ausbildung und regelmäßiges Training der Durchführenden

  • standardisiertes Vorgehen im Team

  • ausgiebige Präoxygenierung

  • optimale Lagerung des Patienten

  • ausreichend tiefe Narkose

  • Einsatz von Muskelrelaxanzien

  • Einsatz eines Videolaryngoskops

• Die Videolaryngoskopie ermöglicht beim eine hohe Erfolgsrate des ersten Intubationsversuchs in der Notfallsituation.

• Videolaryngoskopie ermöglicht eine bessere Sicht auf die Stimmbandebene für den Intubierenden.

• Videolaryngoskopie verbessert durch das für das gesamte Rettungsteam einsehbare Monitorbild des Intubationssitus die Möglichkeiten der Assistenz.

Schlüsselwörter

Intubation - Atemwegssicherung - Notfallmedizin - First-Pass Success

Key words

intubation - emergency - airway management - first-pass success

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