未被识别的药物错误和随后的呼吸道管理,使用超声波引导的甲状腺切除术和Rapid-O2®氧气灌输
Patrick Wong1, Emma E Foster1, Julian B White2
1Department of Anaesthesia and Pain Medicine, Te Whatu Ora Waikato, Hamilton, New Zealand.
Anaesthesia and intensive care
|February 12, 2025
概括
在麻醉期间的药物错误导致在一个困难的呼吸道手术中意外的呼吸暂停. 超声波有助于在触摸失败时识别cricothyroid膜,在这种关键情况下证明有用.
科学领域:
- 麻醉学 麻醉学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 医疗器械 医疗器械
背景情况:
- 无管微鼻镜提高了手术的可及性,但往往需要全静脉麻醉 (TIVA) 输注普罗波福和雷米芬坦尼尔.
- 麻醉错误可能导致患者严重妥协,特别是在呼吸道手术中.
研究的目的:
- 由于输液编程错误,在无管微喉镜检查期间报告一个具有挑战性的意外呼吸暂停病例.
- 突出超声波在紧急呼吸道管理期间识别甲状腺膜的实用性.
主要方法:
- 该案涉及一名接受TIVA开放呼吸道手术的患者.
- 使用Rapid-O2®灌气装置进行了预防性管甲状腺切除术,用于救援氧化.
- 试图通过数字触摸和随后的超声波来识别甲状腺膜.
主要成果:
- 在输液编程过程中未被识别的药物错误导致了意想不到的呼吸暂停.
- 数字触摸未能识别甲状腺膜,但超声波成功.
- 救援氧化是通过cricothyroidotomy小管和灌气装置实现的.
结论:
- 这一案例凸显了TIVA输液可能出现错误的可能性,以及警的重要性.
- 超声波可以是一个有价值的辅助在困难的气道场景中,cricothyroid膜的识别,即使不是标准的护理.
- 预防性cricothyroidotomy与快速氧气灌输可以在"不能输管,不能氧化"的情况下,成为拯救生命的干预措施.
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