Entrenamiento Médico Militar

PROFILE
Airon
Providing Ventilation and CPAP
Systems to EMS since 2003.
ABOUT AIRON CORPORATION
Airon is dedicated to the development, manufacture,
and distribution of safe and effective medical devices
designed for life support. Their expertise and focus is
on pure pneumatic technology that provides dependable,
robust respiratory support of neonates up to the largest
adults.
HIGH QUALITY ICU VENTILATOR TYPE CPAP SYSTEMS
Airon’s products are in use at hospitals and EMS
agencies throughout the world. Airon believes in the
effectiveness of non-invasive ventilation and designs
all of their products with superior CPAP systems to
maximize clinical utility. Recent published research
indicates that Airon’s adult ventilators have CPAP
systems that are equal to or better than modern ICU
ventilators.
RESPIRATORY THERAPISTS WITH CLINICAL EXPERIENCE
The founders and senior management at Airon are
respiratory therapists who have decades of proven
experience working with clinicians in hospitals and
EMS. As a customer-focused company that draws
from the clinical experience of their staff and users,
Airon makes easy-to-use, robust products that meet
the requirements of EMS.
MANUFACTURED IN USA, AVAILABLE WORLDWIDE
Airon’s operations and products comply with local,
national, and international regulations. Every device
is manufactured in their own ISO 13485/9001 certified
facility in Melbourne, Florida. Their products are all
CE marked as well as USA FDA approved. Airon will
only ship products that meet their customers’ quality
requirements.
To learn more about Airon and how they help EMS
professionals obtain improved patient outcomes, visit
AironUSA.com
DESCOMPRESIÓN CON AGUJA
tipo de agujas largas, el abordaje
lateral puede aumentar
el riesgo de lesiones cercanas
a las estructuras vitales. Según
el limitado número de estudios
que han analizado las diferencias
sobre la seguridad del sitio,
parece que el abordaje anterior
está más lejos de las estructuras
vitales y tiene menos posibilidades
de ocasionar lesiones
por la inserción incorrecta de
la aguja. 5 Sin embargo, cuando
se cambia el ángulo de la
aguja por uno perpendicular,
el riesgo de lesiones se vuelve
casi equivalente. 5
En este momento no se han
realizado ensayos controlados
aleatorios prospectivos a gran
escala o metaanálisis que conduzcan
a una declaración por
consenso. Como resultado, la
práctica actual se basa en los
diversos estudios retrospectivos
más pequeños. Estos
estudios presentan datos
débiles si es que no son incluso
contradictorios. Como tal, es
LOS AUTORES
Daniel Charles
Kolinsky, MD,
es un médico
interno de
medicina de
emergencia de
segundo año en
la Universidad de
Washington en
St. Louis, y un graduado del Centro
Estatal de Ciencias de la Salud de
la Universidad de Luisiana. Entre
sus intereses profesionales están
la educación médica, la dinámica
de médico-paciente, y cuidados
críticos de EMS.
Hawnwan Philip
Moy, MD, es
director medico
ayudante del
Departamento
de Bomberos
de San Luis, e
instructor clínico
y miembro de
los profesores de medicina de
emergencia de la Sección SME
de la División de Medicina de
Emergencia de la Universidad
de Washington en Saint Louis,
Missouri. Terminó su residencia
en medicina de emergencia en el
Hospital Judío Barnes / Universidad
de Washington en Saint Louis y su
beca en EMS de la Universidad de
Carolina del Norte en Chapel Hill.
difícil hacer una nueva recomendación de Grado A para cambiarse
al cuarto/quinto espacio intercostal en la línea axilar anterior como
el primer sitio para la descompresión con aguja.
REFERENCES
1. Beckett A, et al. Needle Decompression for Tension Pneumothorax in Tactical Combat Casualty Care: Do Catheters
Placed in the Midaxillary Line Kink More Often Than Those in the Midclavicular Line? J Trauma, 2011; 71: S408–12.
2. Britten S, Palmer SH. Chest wall thickness may limit adequate drainage of tension pneumothorax by needle
thoracocentesis. J Accid Emerg Med, 1996 Nov; 13(6): 426–7.
3. Butler KL, et al. Pulmonary Artery Injury and Cardiac Tamponade after Needle Decompression of a Suspected
Tension Pneumothorax. J Trauma, 2003; 54: 610–11.
4. Carter TE, et al. Needle Decompression in Appalachia Do Obese Patients Need Longer Needles? West J Emerg Med,
2013; 14(6): 650–2.
5. Chang SJ, et al. Evaluation of 8.0-cm needle at the fourth anterior axillary line for needle chest decompression of
tension pneumothorax. J Trauma Acute Care Surg, 2014 Apr; 76(4): 1,029–34.
6. Committee on Trauma, American College of Surgeons. ATLS: Advanced Trauma Life Support—Student Course
Manual, 9th ed. Chicago: American College of Surgeons, 2012.
7. Defense Health Board. Decompression of Tension Pneumothorax Tactical Combat Casualty Care Guideline
Recommendations 2012-05. J Special Op Med, 2012; 12(4): 118–22.
8. Ferrie EP, Collum N, McGovern S. The right place in the right space? Awareness of site for needle thoracocentesis.
Emerg Med J, 2005 Nov; 22(11): 788–9.
9. Inaba K, et al. Optimal Positioning for Emergent Needle Thoracostomy: A Cadaver-Based Study. J Trauma, 2011;
71: 1,099–103.
10. Inaba K, et al. Radiologic evaluation of alternative sites for needle decompression of tension pneumothorax. Arch
Surg, 2012 Sep; 147(9): 813–8.
11. Martin M, Satterly S, Inaba K, Blair K. Does needle thoracostomy provide adequate and effective decompression of
tension pneumothorax? J Trauma Acute Care Surg, 2012 Dec; 73(6): 1,412–7.
12. Miller AC, et al. Guidelines for the management of spontaneous pneumothorax. BMJ, 1993; 307: 114–16.
13. Rawlins R, et al. Life threatening haemorrhage after anterior needle aspiration of pneumothoraces. A role for
lateral needle aspiration in emergency decompression of spontaneous pneumothorax. Emerg Med J, 2003 Jul;
20(4): 383–4.
14. Sanchez LD, et al. Anterior versus lateral needle decompression of tension pneumothorax: comparison by
computed tomography chest wall measurement. Acad Emerg Med, 2011 Oct; 18(10): 1,022–6.
15. Stevens RL, et al. Needle thoracostomy for tension pneumothorax: failure predicted by chest computed
tomography. Prehosp Emerg Care, 2009 Jan-Mar; 13(1): 14–7.
16. Warner KJ, Copass MK, Bulger EM. Paramedic use of needle thoracostomy in the prehospital environment.
Prehosp Emerg Care, 2008 Apr–Jun; 12(2): 162–8.
17. Wax DB, et al. Radiologic assessment of potential sites for needle decompression of a tension pneumothorax.
Anesth Analg, 2007 Nov; 105(5): 1,385–8.
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16 MARZO 2015 | EMSWORLD.com