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
