abstracts 2010 - Schweizerische Gesellschaft für Gebirgsmedizin

-15°C - Wind Nordwest 40 km/h
wish vs. reality
good vs. bad conditions
� human resources
� material ressources
� meteorological influences
� geographical influences
�time limits and time required for
transport/rescue
� „golden hour of shock“ rising mortality the longer you need
� specalized rescue techniques take time
� aerial descends can take several hours/days or are only
possible to a safe shelter
benefit-risk-ratio
-highly specialised and
+ optimized ventilation
+ protection against continuously trained personal needed
aspiration
+ possibilty to suck off
-up to 25% unsuccessful attempts in
mucus, blood, puke
+ safe airway even endotracheal intubation by paramedics
when severe swelling in
the pharynx or larynx
-„fatal „ attempts p were frequent“ q
occurs
Effect of out-of-hospital pediatric endotracheal intubation
on survival and neurological outcome JAMA 2000; GAUSCHE et al
-up to 6,7% esophageal intubation by
non-anesthesiological emergency physicians
in Germany
The out-of-hospital esophagial and endobronchial
intubations performed by emergency physiians;
Critical Care and Trauma 2007; TIMMERMANN et al
-100% endotracheal intubations by
anesthesiology based HEMS-physicians
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wish vs. reality
good vs. bad conditions
� human resources
� material ressources
� meteorological influences
�geographical geographical influences
� place to work safely/environment/steep slope/rockfall
� rescue the patient from bad environment into „safety“
before treating him medically
Gold-Standard – Intubation
+ optimized ventilation
+ protection against
aspiration
+ possibilty to suck off
mucus mucus, blood, blood puke
+ safe airway even
when severe swelling in
the pharynx or larynx
occurs
KISS
Keep
It
Simple +
Safe
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