Author/Editor		Aplenc, Primož
Title		Problemi vzpostavitve dihalne poti pri poškodovancih na terenu
Translated title		The problems associated with the maintenance of the patent airway in cases of field injuries
Type		članek
Source		In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 4. Zbornik 5. mednarodni simpozij o urgentni medicini; 1998 jun 17-20; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		1998
Volume		str. 221-2
Language		eng
Abstract		The maintenance of the artificial patent airway is necessary in numerous cases of sickness or injury. However in individual cases the physician is faced with dilemma regarding this actions. The following case ilustrates this well. The patient shot himself in the Lower jaw with a rifle and the bullet stopped in the hard pallate. The injury of the lower jaw and the hard pallate asociated with a thorn tissue and the injury of the lower jaw bone structure caused intensive bleeding into the mouth cavity.This was considered to be an absolute indication for intubation.lt would be necessary to relax the patient and preform analgetic therapy before the intubation. Neither the classic intubation nor the intubation with combitube proved to be succesful. The analgesy was established while the relaxation was not. After the unsuccesful intubation attempts the patient was transported to the hospital reanimation room while continouing blood aspiration from the mouth cavity using the aspiration catheter and the maximum application of 100% oxygen and infusional therapy was applied. In the hospital reanimation room, following another unsuccesful intubation attempt,the surgeon established the artificial airway preforming the urgent tracheotomy. Later it was established that the trachea was narrowed to a diameter of .3 - 4 mm, following the earlier injure of the segment of the thyroid cartilage. Considering this case the following questions may be raised: 1. What should be the optimal treatment of such patient. 2. Would the relaxation cause a lethal outcome because the intubation was not possible and the maintaining the patent airway with the use of the ventilation mask or the airway would be ineffective because of multiple injuries of the oral cavity. 3. Would it be sensible to try the conicotomy in this case - the fact is that up to now no case of field conicotomy has been performed in Slovenia. (Abstract truncated at 2000 characters)
Descriptors		EMERGENCY MEDICAL SERVICES AIRWAY OBSTRUCTION INTUBATION, INTRATRACHEAL