临床麻醉学英文版.pdf

精品文档 CHAPTER 3 Managing the Airway Basic techniques, 37 The laryngeal mask airway, 42 Emergency airway Simple adjuncts, 39 Tracheal intubation, 43 techniques, 50 Maintenance of a patent airway is an essential prerequisite for the safe and successful conduct of anesthesia. In addition, during resuscitation patients often have an obstructed airway either as the cause or result of their loss of consciousness. The skill of airway maintenance should be acquired by all doctors, and not simply regarded as the responsibility of the anesthetist. The descriptions of airway management techniques, which follow, are intended to supplement practice either on a manikin or preferably on and anesthetized patient under the direction of a skilled anesthetist. Basic techniques Anesthesia frequently results in loss of the airway and it is most easily restored by a combination of the head tilt along with a jaw thrust (see Chapter 2). The latter is provided by the anesthetist ’s fourth and fifth fingers (of one or both hands) lifting the angle of the mandible. The overall effect desired is that the patient ’s mandible is into the mask rather than the mask being pushed into the face (Fig. 3.1). FACEMASKS The most commonly used type in adults is the BOC anatomical facemask (Fig. 3.2) which is designed to fit the contours of the face with the minimum of pressure. Leakage of anesthetic gases is minimized by an air-filled cuff around the edge. Masks ate made in a variety of sizes and the smallest one, which