Coniotomie: Comment en situation isolée ?
Optimizing Emergent Surgical Cricothyrotomy for use in Austere Environments.
Etre en capacité d'ouvrir le cou en cas d'instruction des voies aériennes est un savoir faire essentiel à la médicalisation de l'avant. Il n'est pas nécessaire de disposer de kit sophistiqué pour cela. une lame de bistouri de 20, un mandrin et une canule/sonde de 6 mm suffisent. C'est ce qu'exprime ce document.
Emergent cricothyrotomy is an infrequently performed procedure used in the direst of circumstances on the most severely injured patients. Austere environments present further unique challenges to effective emergency medical practice. Recently, military trauma registry data were searched for the frequency of cricothyrotomy use and success rates during a 22-month period. These data revealed that cricothyrotomy performed in the most rigorous austere environment (ie, battlefield) had many successes, but also a large number of failed (33%) attempts by medics owing to many factors. Thus, the aim of this review article is to present what is known about cricothyrotomy and apply this knowledge to any austere environment for qualified providers. The National Library of Medicine’s PubMed was used to conduct a thorough search using the terms “prehospital,” “cricothyroidotomy,” “cricothyrotomy,” and “surgical airway.” The findings were further narrowed by applicability to the austere environment. This review presents relevant airway anatomy, incidences, indications, contraindications, procedures, and equipment, including improvised devices, success rates, complications, and training methods. Recommendations are proffered for ways to optimize procedures, equipment, and training for successful application of this emergent skill set in the austere environment.