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題名 | Airway Fire during Tracheostomy--A Case Report=氣管切開術中因電燒引發呼吸道著火--病例報告 |
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作者 | 陳貽誠; 魏昌國; 謝瑞龍; 戴禹鑌; 賴裕永; Chen, I-cheng; Wei, Chang-kuo; Sia, Swee-leong; Tai, Yu-pin; Lai, Yu-yung; |
期刊 | 慈濟醫學 |
出版日期 | 20051000 |
卷期 | 17:5 民94.10 |
頁次 | 頁373-376+387 |
分類號 | 416.2151 |
語文 | eng |
關鍵詞 | 氣管內管; 氣管切開術; 電燒; 呼吸道著火; Endotracheal tube; ETT; Tracheostomy; Electrocautery; Airway fire; |
中文摘要 | 因電燒或雷射引發氣管內管燃燒的呼吸道著火意外在過去幾年中已被廣泛討論。雖然發生率很低,但是一旦發生卻很容易導致病人死亡或嚴重傷害。我們報告一個在進行氣管切開術時,因電燒引發氣管內管著火的病例。發生著火的主要原因是因為我們使用純氧換氣,以及為了止血將電刀設定在高能量功率輸出狀態。在報告中,我們也討論目前在手術中預防呼吸道著火的方法以及當呼吸道著火時的緊急處理方法。我們建議在決定是否要拔掉氣管內管前應先:(1)使用水對氣管內管沖洗,以確定呼吸道內沒有殘留的火焰。(2)使用光纖支氣管內視鏡檢查氣管內管是否阻塞。(3)慎重衡量拔除氣管內管的優缺點。雖然呼吸道著火很少發生,麻醉科醫師及外科醫師必須牢記其緊急處理方法並熟悉預防的方法。 |
英文摘要 | Airway fire resulting from igniting an endotracheal tube (ETT) with electrocautery or lasers has been widely discussed recently. Despite its rare incidence, it can lead to mortality or severe injury. We will present a case of an ETT fire caused by electrocautery during tracheostomy. In this case, the primary causes of fire were the pure oxygen used for ventilation and the high power electrocautery used for control of bleeding. In this report, we also discuss methods of prevention of an airway fire and emergency treatment when it occurs. Before making a decision to exubate the patient, we suggest (1) using water for ETT lavage in order to assure that there is no residual flame in the airway (2) using fibrobronchoscopy to check that the ETT lumen is not occluded and (3) weighing the benefits and risks of removing the burnt ETT. Despite of its rare occurrence, anesthesiologists and surgeons should keep emergency treatment of airway fires in mid and be aware of methods of prevention. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。