Traumatisme toracice rapid letale - Cursul National de Ghiduri si ...
Traumatisme toracice rapid letale - Cursul National de Ghiduri si ...
Traumatisme toracice rapid letale - Cursul National de Ghiduri si ...
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Tipuri leziuni care nece<strong>si</strong>ta un management special:<br />
1. Leziuni maxilofaciale severe<br />
2. Traume penetrante sau inchise ale cailor aeriena extra<strong>toracice</strong><br />
3. Leziuni traheale intraoracice<br />
1. Leziuni maxilofaciale severe<br />
⇒ IOT impo<strong>si</strong>bilitatea <strong>de</strong> intubatie calea chirurgicala<br />
2. <strong>Traumatisme</strong> penetrante sau inchise ale caior aeriene extra<strong>toracice</strong><br />
(vezi fig. 4, pe pagina urmatoare)<br />
3. Leziuni traheale intra<strong>toracice</strong><br />
Timisoara 2007<br />
Pacient<br />
Apnee ventilatie ina<strong>de</strong>cvata<br />
IOT *1 IOT cu RSI<br />
Impo<strong>si</strong>bilitate <strong>de</strong> IOT Impo<strong>si</strong>bilitate <strong>de</strong> IOT *1<br />
Calea chirurgicala *2<br />
1* Combitube sau LMA<br />
2* Calea chirurgicala: cricotiroidotomia pe ac, cricotiroidotomia<br />
chirurgicala, traheotomia<br />
Figura 3. Managementul 3. Managementul general general al protezarii al protezarii cailor aeriene cailor in aeriene caz <strong>de</strong> obstructie in caz <strong>de</strong> (1)<br />
obstructie (1)<br />
Suspiciune <strong>de</strong> leziune traheala intratoracica<br />
Nece<strong>si</strong>ta controlul <strong>rapid</strong> al cailor aeriene Nu nece<strong>si</strong>ta control <strong>rapid</strong> al cailor aeriene<br />
IOT Bronhoscopie<br />
Bronhoscopie cu plasarea tubului Leziune Fara leziune<br />
dincolo <strong>de</strong> leziune<br />
sau in bronhia<br />
controlaterala IOT cu bronhoscopie Observare<br />
Interventie chirurgicala Interventie chirurgicala<br />
Figura 5. Figura Managementul 5. Managementul cailor cailor aeriene in caz <strong>de</strong> <strong>de</strong> leziuni leziuni traheale traheale intra<strong>toracice</strong> intra<strong>toracice</strong> (1)<br />
(1)<br />
333
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