BACKGROUND:In developing countries with limited access to ENT services, performing emergency cricothyroidotomy in patients with upper airway obstruction may be a life-saving last resort. An established Danish-Zimbabwean collaboration of otorhinolaryngologists enrolled Zimbabwean doctors into a video-guided simulation training programme on emergency cricothyroidotomy. This paper presents the positive effect of this training, illustrated by two case reports. CASE REPORTS:A 56-year-old female presented with upper airway obstruction due to a rapidly progressing infectious swelling of the head and neck progressing to cardiac arrest. Cardiopulmonary resuscitation was initiated and a secure surgical airway was established via an emergency cricothyroidotomy, saving the patient. A 70-year-old male presented with upper airway obstruction secondary to intubation for an elective procedure. When extubated, the patient exhibited severe stridor followed by respiratory arrest. Re-intubation attempts were unsuccessful and emergency cricothyroidotomy was performed to secure the airway, preserving the life of the patient. CONCLUSION:Emergency cricothyroidotomy training should be considered for all surgeons, anaesthetists and, eventually, emergency and recovery room personnel in developing countries. A video-guided simulation training programme on emergency cricothyroidotomy in Zimbabwe proved its value in this regard.

译文

背景:在获得耳鼻喉科服务机会有限的发展中国家,对上呼吸道阻塞的患者进行紧急环颈切开术可能是挽救生命的最后选择。丹麦-津巴布韦的耳鼻喉科医生建立了良好的合作关系,使津巴布韦的医生参加了有关紧急环颈切开术的视频指导模拟培训计划。本文通过两个案例报告展示了这种培训的积极效果。
病例报告:一名56岁的女性由于快速发展的头颈部传染性肿胀发展为心脏骤停而出现上呼吸道阻塞。开始进行心肺复苏术,并通过紧急环颈切开术建立了安全的手术气道,从而挽救了患者的生命。一名70岁的男性因插管手术而出现继发于插管的上呼吸道阻塞。拔管时,患者表现出严重的喘鸣,随后呼吸停止。重新插管尝试未成功,并进行了紧急环颈切开术以确保气道安全,从而挽救了患者的生命。
结论:应考虑对发展中国家的所有外科医生,麻醉师,以及最终急诊室和恢复室人员进行紧急环颈切开术培训。在津巴布韦进行紧急环颈切开术的视频指导模拟培训计划证明了其在这方面的价值。

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