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Part 3. Clinical Practice Guideline for Airway Management and Emergency Thoracotomy for Trauma Patients from the Korean Society of Traumatology

Journal of Trauma and Injury 2020년 33권 3호 p.195 ~ 203
박찬용, Kim O-Hyun, 장성욱, 최강국, 이경학, 김성엽, 김마루, 이길재,
소속 상세정보
박찬용 ( Park Chan-Yong ) - Wonkwang University Hospital Department of Trauma Surgery
 ( Kim O-Hyun ) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
장성욱 ( Chang Sung-Wook ) - Dankook University Hospital Department of Thoracic and Cardiovasular Surgery
최강국 ( Choi Kang-Kook ) - Gachon University College of Medicine Department of Traumatology
이경학 ( Lee Kyung-Hak ) - National Medical Center Department of Orthopedic Surgery
김성엽 ( Kim Seong-Yup ) - Yonsei University Wonju College of Medicine Wonju Severance Christian Hospital Department of Surgery
김마루 ( Kim Ma-Ru ) - Catholic University College of Medicine Uijeongbu St. Mary’s Hospital Department of Trauma Surgery
이길재 ( Lee Gil-Jae ) - Gachon University College of Medicine Department of Traumatology

Abstract


The following key questions and recommendations are presented herein: when is airway intubation initiated in severe trauma? Airway intubation must be initiated in severe trauma patients with a GCS of 8 or lower (1B). Should rapid sequence intubation (RSI) be performed in trauma patients? RSI should be performed in trauma patients to secure the airway unless it is determined that securing the airway will be problematic (1B). What should be used as an induction drug for airway intubation? Ketamine or etomidate can be used as a sedative induction drug when RSI is being performed in a trauma patient (2B). If cervical spine damage is suspected, how is cervical protection achieved during airway intubation? When intubating a patient with a cervical spine injury, the extraction collar can be temporarily removed while the neck is fixed and protected manually (1C). What alternative method should be used if securing the airway fails more than three times? If three or more attempts to intubate the airway fail, other methods should be considered to secure the airway (1B). Should trauma patients maintain normal ventilation after intubation? It is recommended that trauma patients who have undergone airway intubation maintain normal ventilation rather than hyperventilation or hypoventilation (1C). When should resuscitative thoracotomy be considered for trauma patients? Resuscitative thoracotomy is recommended for trauma patients with penetrating injuries undergoing cardiac arrest or shock in the emergency room (1B).

키워드

Airway management; Thoracotomy; Practice guideline; Wounds and injuries

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