CERVICAL-SPINE MOVEMENT DURING AIRWAY MANAGEMENT - CINEFLUOROSCOPIC APPRAISAL IN HUMAN CADAVERS

被引：47

作者：

HAUSWALD, M

SKLAR, DP

TANDBERG, D

GARCIA, JF

机构：

[1] Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM

[2] Department of Radiology, University of New Mexico School of Medicine, Albuquerque, NM

来源：

AMERICAN JOURNAL OF EMERGENCY MEDICINE | 1991年 / 9卷 / 06期

关键词：

BIOMECHANICS; NECK; SPINE; CERVICAL VERTEBRAE; SPINAL CORD INJURIES; MOVEMENT; INTUBATION; INTRATRACHEAL;

D O I：

10.1016/0735-6757(91)90106-T

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

The objective of this study was to determine which airway maneuvers cause the least cervical spine movement. A controlled laboratory investigation was performed in a radiologic suite, using eight human traumatic arrest victims who were studied within 40 minutes of death. All subjects were ventilated by mask and intubated orally, over a lighted oral stylet and flexible laryngoscope, and nasally. Cinefluoroscopic measurement of maximum cervical displacement during each procedure was made with the subjects supine and secured by hard collar, backboard, and tape. The mean maximum cervical spine displacement was found to be 2.93 mm for mask ventilation, 1.51 mm for oral intubation, 1.65 mm for guided oral intubation, and 1.20 mm for nasal intubation. Ventilation by mask caused more cervical spine displacement than the other procedures studied (ANOVA; F = 9.298; P = .00004). It was concluded that mask ventilation moves the cervical spine more than any commonly used method of endotracheal intubation. Physicians should choose the intubation technique with which they have the greatest experience and skill. © 1991.

引用

页码：535 / 538

页数：4

共 34 条

[1]

Sinha, Ducker, Perot, Arterial oxygenation: Findings and its significance in central nervous system trauma patients, JAMA, 224, pp. 1258-1260, (1973)

[2]

Vicario, Coleman, Cooper, Et al., Ventilatory status early after head injury, Ann Emerg Med, 12, pp. 145-148, (1983)

[3]

Majernick, Bieniek, Houston, Et al., Cervical spine movement during orotracheal intubation, Ann Emerg Med, 15, pp. 417-420, (1986)

[4]

Grande, Barton, Stene, Appropriate techniques for airway management of emergency patients with suspected spinal cord injury, Anesth Analg, 67, pp. 714-715, (1988)

[5]

Talucci, Shaikh, Schwab, Rapid sequence induction with oral endotracheal intubation in the multiply injured patient, Am Surg, 54, pp. 185-187, (1988)

[6]

Holley, Jorden, Airway management in patients with unstable cervical spine fractures, Ann Emerg Med, 18, pp. 1237-1239, (1989)

[7]

Rhee, Green, Holcroft, Et al., Oral intubation in the multiply injured patient: The risk of exacerbating spinal cord damage, Ann Emerg Med, 19, pp. 511-514, (1990)

[8]

Vollmer, Stewart, Paris, Et al., Use of a lighted stylet for guided orotracheal intubation in the prehospital setting, Ann Emerg Med, 14, pp. 324-328, (1985)

[9]

Wang, Reves, Gutierrez, Awake fiber-optic laryngoscopic tracheal intubation for anterior cervical spinal fusion in patient with cervical cord trauma, Int Surg, 64, pp. 69-72, (1979)

[10]

Rogers, Benumof, New and easy techniques for fiber-optic endoscopy-aided tracheal intubation, Anesthesiology, 59, pp. 569-572, (1983)

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