Ulaş E. SAZ, Çiğdem ARIKAN, Sema AYDOĞDU

Çocuklarda Hızlı ve Seri Entübasyon

Hızlı ve seri entübasyon; entübasyonun daha güvenli ve kolay, daha hızlı ve az travmatik yapılmasını sağlamak amacıyla birtakım nöromuskuler blokörlerin ve sedatif ajanların kullanılması suretiyle oluşturulduğu bir yöntemdir. Çocuk acil servislerinde entübasyon gerektiren hastalarda kullanımı giderek yaygınlaşan ve pediatrik resusitasyon kurslarında eğitimi verilen bir yöntem olmaya başlamıştır. Çalışmaların çoğunda hızlı ve seri entübasyonun HSE klasik entübasyon yöntemlerinden daha fazla tercih edildiği görülmüştür. 7000’den fazla hasta içeren geniş bir prospektif çalışmada hastaların %78’inde HSE yönteminin kullanıldığı vurgulanmıştır. HSE, daha başarılı bir yöntem olması nedeniyle genellikle acil servislerde ilk olarak tercih edilmektedir. Nitekim bu farklılık, az sayıda hasta içeren birçok retrospektif ve çok sayıda hasta içeren bir tane prospektif çalışmada açıkça ortaya konulmuştur. HSE, ileri havayolu yönetiminde eğitilmiş ve sedatif paralitik doz bilgisine sahip acil servis pediatristlerinin güvenle uygulayabilecekleri bir yoldur. HSE birçok pediatrik seride ve erişkinlerde yapılmış daha geniş kapsamlı çalışmalarda gösterilmiştir.

Anahtar Kelimeler:

Entübasyon, hızlı, çocuk

Rapid Sequence Intubation in Children

Rapid sequence intubation RSI is a commonly used technique in the emergency department ED to facilitate the placement of an emer- gency airway. This technique is the performance of intubation with sedatives and neuromusculer blockade, with the objective of mak- ing procedure quicker, easier and less traumatic. Patients that are candidates for RSI are all those who require intubation and have vary- ing levels of consciousness and with any suspicion of a full stomach. The Core Content for Emergency Medicine EM recommends that all emergency physicians should be trained to manage the airway, including administering paralytic agents for endotracheal intubation. Emergent intubations can be performed with or without sedation and paralysis. The vast majority are performed using RSI, a specific intubation technique that involves sedation and paralysis, with airway protection. This was demonstrated in a large prospective series including more than 7000 patients, in which 78 percent of intubations were performed using RSI.

Keywords:

Intubation, rapid, child,

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