#1
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Ëàðèíãîñêîï
Óâàæàåìûå êîëëåãè, êòî-íèáóäü þçàë òàêîé äåâàéñ:
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#2
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×åòî íå ñëûøàë, îò êîëëåã, ÷òîáû êòî-òî ýòî èñïîëüçîâàë. Äëÿ òðóäíîé èíòóáàöèè íà çàïàäå äîñòàòî÷íî ÷àñòî èñïîëüçóåòñÿ ãëàéäîñêîï, âîò åãî ìíîãèå ðåêîìåíäóþò è èñïîëüçóþò ðóòèííî, õîòÿ ñ íèì ïðîöåäóðà èíòóáàöèè ñóùåñòâåííî çàòÿãèâàåòñÿ.
Áûëî èññëåäîâàíèå, â êîòîðîì ñðàâíèâàëèñü ýòè äåâàéñû: http://bja.oxfordjournals.org/cgi/reprint/aen231v1.pdf Öèòàòà:
Öèòàòà:
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#3
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×åì-òî íàïîìíèëî, êñòàòè ..
Laryngoscope by Mathieu 1880 An indirect laryngoscope (because the larynx was not seen directly, but indirectly through the reflection of a mirror). The gag reflex would be suppressed using crushed ice (after 1884 cocaine spray was used as a local anaesthetic). The bottom blade of the speculum would hold down the tongue whilst the top blade would be positioned against the soft palate so that a light source would illuminate the mirror. In turn the mirror would reflect back a view of the larynx and glottis. The first laryngoscope was attributed to Manuel Garcia (a Spanish singing professor) in 1854. It was quickly adopted by the medical profession; initially Ludwik Turk in Vienna, Czermak in Budapest and in England Morell Mackenzie pioneered the development of laryngology. This rare French example signed Mathieu Paris (Brevete) probably dates to the last 1/4 of the 19th century http://www.phisick.com/a7laryngo.htm [Èçîáðàæåíèÿ äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì] [Èçîáðàæåíèÿ äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì] |
#4
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Íàøåë ðîëèê íà þòþáå.
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#5
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Òðîãàëà ñåé óæàñ íå÷åëîâå÷åñêèé ðóêàìè íà êàêîé-òî âûñòàâêå. Ïîðàäîâàëàñü, ÷òî â ìëàäåíöà òàêîå íå çàïèõàåøü.
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#6
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#7
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Îáúåìîì, êîòîðûé çàíèìàåò ñåé äåâàéñ â ðîòîâîé ïîëîñòè.
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#8
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#9
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Âåðþ, ÷òî ïèøåò. Íî îùóùåíèÿ áûëè èíûå.
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#10
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Íàäåþñü ñêîðî ïîïðîáîâàòü ýòîò ëàðèíãîñêîï â äåéñòâèè è òîãäà ïîäåëþñü âïå÷àòëåíèÿìè.
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#11
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Öèòàòà:
À âîáùå â ñëó÷àå íåïðîãíîçèðóåìîé òðóäíîé èíòóáàöèè â áîëüøèíñòâå ñëó÷àåâ - ïðèîðèòåò âåíòèëÿöèÿ, à íå èíòóáàöèÿ. Ñì. ðåêîìåíäàöèè "Îáùåñòâà Òðóäíûõ Äûõàòåëüíûõ Ïóòåé". |
#12
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À êàêîå óñòðîéñòâî Âû ïîðåêîìåíäóåòå â ñëó÷àÿõ íåîáõîäèìîñòè èíòóáàöèè òðàõåè ó áîëüíûõ ïðè ÑËÐ, êîãäà âðåìÿ èìååò çíà÷åíèå?
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#13
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Çàâèñèò îò êîíêðåòíûõ óñëîâèé è îáñòîÿòåëüñòâ. Èíòóáèðîâàòü äîëæíû òîëüêî àíåñòåçèîëîãè.
Áûñòðåå âñåãî è ïðîùå áóäåò óñòàíîâèòü ëàðèíãåàëüíóþ ìàñêó. Â ñëåäóþùåé ðåäàêöèè ALS âìåñòî èíòóáàöèè íà äîãîñïèòàëüíîì ýòàïå áóäåò ðåêîìåíäîâàíî èñïîëüçîâàíèè i-gel, èëè LMA Supreme: [Èçîáðàæåíèÿ äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì] |
#14
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Öèòàòà:
Íàøà îñíîâíàÿ ïîòðåáíîñòü - ýòî ÈÂË ó âíåçàïíî óìåðøèõ áîëüíûõ, ÷àñòî â íåïðèñïîñîáëåííûõ äëÿ ýòîãî óñëîâèÿõ è ó "íåïîäãîòîâëåííûõ" áîëüíûõ ñ îñòðîé ëåâîæåëóäî÷êîâîé íåäîñòàòî÷íîñòüþ â ñîçíàíèè. |
#15
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Åñëè âû äåëàåòå èíòóáàöèþ äîñòàòî÷íî ðåäêî, ìîæåò áûòü ýòî è íåïëîõîé âàðèàíò. Òåì áîëåå, åñëè îí Âàì ïîíðàâèëñÿ.
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