Die Notfallkoniotomie ist eine seltene lebensrettende Intervention, um bei Patienten, die weder intubiert noch beatmet werden können, schnell Zugang zu den Atemwegen zu erhalten. In Anbetracht der möglichen Komplikationen hängt der Erfolg von der Erfahrung des Notfallmediziners ab. In diesem Beitrag wird eine Auswahl handelsüblicher Koniotomie-Sets vorgestellt und Indikationen für deren Anwendung werden skizziert.
Abstract
Emergency cricothyrotomy is a live saving intervention to rapidly gain access to the airways in patients who cannot be intubated nor ventilated. Considering complications such as bleeding, thyroid and cricoid cartilage injury and creation of a false tract emergency cricothyrotomy should not be performed until non-invasive attempts including video laryngoscopy and the use of supraglottic airway devices have been exploited within a fixed difficult airway management algorithm. Methods of emergency cricothyrotomy can be differentiated in a catheter-over-needle, Seldinger-wire and surgical technique. However, success is less dependent from the choice of method but from individual experience and training. Despite a lack of evidence due to its infrequent use cricothyrotomy generally results in an acceptable success rate. In this review a selection of commercially available cricothyrotomy sets is presented, indications for their use are outlined and their handling is described.
Schlüsselwörter
maschinelle Beatmung - Atemwegsmanagement - Tracheotomie
Key words
mechanical ventilation - airway management - tracheotomy
