光纤维棒插管.pdfVIP

Fiber-Optic Stylet Intubation 17 (Rigid and Semirigid) Joseph Rabinovich 17.1 Indications 17.2 Contraindications • For use in routine and predicted diffi cult oral • Complete upper airway obstruction where surgical airway intubations. is indicated • Similar to a fl exible fi ber-optic scope with the specifi c • Oral pharyngeal swelling requiring a nasotracheal or sur- advantages of: gical approach – Less setup time • Failed airway and unable to adequately maintain oxygenation – Less time to perform the procedure – Appropriate for routine intubations (and easier to accumulate experience) 17.3 Relative Contraindications – Rigid enough to lift up the epiglottis – Easier to navigate through tissue • Large amounts of blood and secretions may obscure visu- – Less susceptible to being obscured by blood and alization of the airway and cords. secretions • Very distorted airways. Compared with fl exible endos- – More durable, more portable, easier to clean, and less copy, this device is less maneuverable. expensive • Particularly useful when neck mobility or mouth opening is restricted. 17.4 Materials and Medications • Advantageous in awake intubations because it can mini- mize tissue contact,