Title:
Protection of respiratory integrity and haemodynamic stabilization
Authors:
X. Muschart , V. Domjan , E. Mergny and J.-B. Watelet
Institutions:
Université catholique de Louvain, CHU UCL Namur, Service des Urgences, site Godinne, 5530 Yvoir, Belgium; AZ Sint Jan, Campus Sint-Jan, Ruddershove 10, 8000 Bruge, Belgium; Université catholique de Louvain, CHU UCL Namur, Service des Urgences, site Dinant, 5530 Yvoir, Belgium; Department of Otorhinolaryngology, Gent University Hospital, 9000 Gent, Belgium
Keywords:
Protection of the respiratory integrity, airway, haemodynamic stabilization, circulation
Pages:
55 - 66
Abstract:
Protection of respiratory integrity and haemodynamic stabilization. Objectives: To perform an analysis of the protection of respiratory integrity and haemodynamic stabilization based on the literature review and the experiences and perspectives of emergency and ENT specialists. Methodology: Acomprehensive literature search was undertaken through PubMed and MEDLINE, using the following keywords: [protection of the respiratory integrity], [intubation], [hypotension] and [haemodynamic stabilization]. Articles were selected if the topic was relevant to current ENT and emergency practice. Additional articles were identified through a careful review of reference lists in Uptodate.Acritical review of ENT and emergency specialists was carried out. Evidence staging and recommendation levels were established using the Paul Shekelle scale. Results : Firstly, protection of the airway is necessary before starting haemodynamic stabilization. Fibre-optic examination and laryngeal intubation form the gold standard of diagnosis and treatment in the protection of the airway. For circulation, a short catheter with a large size allows the management of intravenous fluids, with vasopressors if necessary. Aetiologic and specific treatments are also very important. Conclusions : Appropriate and collaborative management is necessary with the “ABCDE” approach: Airway and im- mobilization of the neck; Breathing; Circulation; Disability and Exposure.Afibre-optic examination is the gold standard of airway diagnosis. Laryngeal intubation is the most effective treatment for protection of the respiratory integrity. The management of circulation includes the implementation of a venous route to initiate administration of IVFs, preferably with isotonic saline. Vasopressors and inotropes are used as second line agents.Amultidisciplinary and team approach is preferred, in order to achieve diagnosis and therapeutics simultaneously.
Issue:
Suppl. 26.1, 2016


Download:
Protection of respiratory integrity and haemodynamic stabilization