新英格兰杂志4月26日公布的气管插管规范(编译完毕,中文版PDF).doc

【文摘发布】新英格兰杂志4月26日公布的气管插管规范（编译完毕，中文版PDF） RESOURCE: NEJM，Volume 356:e15 April 26, 2007 Number 17 TITLE: Orotracheal IntubationAUTHOR: Christopher Kabrhel, M.D., Todd W. Thomsen, M.D., Gary S. Setnik, M.D., and Ron M. Walls, M.D.Chapters:1、Indications2、Contraindications3、Equipment4、Preparation5、Sedation and Paralysis6、The Procedure7、Troubleshooting8、Confirmation9、Securing the Tube10、Complications本文是《新英格兰杂志》4月26日发表的，气管插管在临床上常用，本文提供了一个指南，请有兴趣的战友翻译，分成12，3，4，5，6，7，8，9、10部分，8人完成 e15.pdf (192.06k) INDICATIONSOrotracheal intubation is indicated in any situation that requires definitive control of the airway. Orotracheal intubation is commonly performed to facilitate control of the airway in a patient undergoing general anesthesia. It is also performed as part of the care of critically ill patients with multisystem disease or injuries. Emergency indications include cardiac or respiratory arrest, failure to protect the airway from aspiration, inadequate oxygenation or ventilation, and existing or anticipated airway obstruction.适应症气管插管适用于任何确实需要气道管理的状况。为了便于气道管理，患者全身麻醉时常常需要气管插管;气管插管也是多系统疾病或损害的危重患者监护的一部分。紧急适应症包括心跳或呼吸骤停、气道不能防止误吸、缺氧或通气不足、气道阻塞。CONTRAINDICATIONS禁忌症In urgent situations or emergencies, such as when a patient is in cardiac arrest,airway management is of paramount importance, and there are very few contraindications to orotracheal intubation. Orotracheal intubation by direct laryngoscopy is somewhat contraindicated in a patient with partial transection of the trachea, because the procedure can cause complete tracheal transection and loss of the airway.在紧急状态下或急症时，如患者心跳骤停，气道管理极为重要，但气管插管仍有极少的禁忌症。直接喉镜下气管插管对已行部分气管切除的患者相对禁忌，因为气管插管步骤导致气管全部横断及气道损伤。In these cases, surgical airway management may be necessary. Unstable cervical spine injury is not a contraindication, but strict, in-line stabilization of the cervical spine must be maintained during intubation. An assistant should stand at the side of the bed and hold the patient’s head, neck,