Zusammenfassung
Wegen einer während ca. drei Stunden zunehmenden Dyspnoe sucht ein 46-jähriger, ansonsten gesunder Patient, seinen Hausarzt auf. Aufgrund der schweren Dyspnoe bei klassischer Epiglottitissymptomatik alarmiert der Hausarzt sofort den Rettungsdienst. Trotz konservativer Therapie verschlechtert sich die Dyspnoe weiter, so dass während des Transportes bei unmöglicher Maskenbeatmung die Notfallkoniotomie mit einem Skalpell durchgeführt wird. Der Patient kann in der Folge suffizient beatmet werden und überlebt das Ereignis ohne bleibende Schäden.
Emergency Cricothyroidotomy in Upper Airway Obstruction in Adult Epiglottitis
A 46-year old man, who is in otherwise good health, visits his family doctor after a 3 hour period of increasing dyspnoea. The family doctor considered the severe dyspnoe to be die to classic epiglottitis and alerts the ambulance for transfer to the hospital. In spite of medical therapy and attempts to mask ventilate, the dyspnoea progressed to complete airway obstruction. An emergency cricothyroidotomy was performed. Sufficent ventilation and oxygenation was provided, the patient survived and returned to normal health.
Schlüsselwörter
Dyspnoe - Epiglottitis - Can not ventilate, can not intubate - Koniotomie
Key words
Dyspnoe - Epiglottitis - Can not ventilate, can not intubate - Cricothyroidotomy
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Dr. med. Wilhelm Ruppen
Institut für Anästhesie und Reanimation Kantonsspital Luzern
6000 Luzern 16
Schweiz
