Weinmann MEDUVENT Standard - Page 18

Indications for prehospital emergency anaesthesia
• Acuterespiratoryinsufciency(hypoxiaand/orrespiratoryrate*
< 6 or > 29/min) and contraindications for or failure of non-invasive ventilation
• Lossofconsciousness/neurologicaldecitwithriskofaspiration
• Multiple trauma/severe trauma with
i) hemodynamic instability, systolic BP < 90 mmHg or
ii) hypoxia with SpO
2
< 90% despite = 2 l/min O
2
administration or
iii) traumatic brain injury with GCS < 9
*inthepresenceofnotrapidlyreversiblecauses
Excerpt from the S1 guideline
”Prehospital Emergency Anaesthesia in Adults” of the DGAI
(German Society for Anesthesiology & Intensive Care Medicine)
If required
Management of complications
Indication: patient-, mission-, and user-related factors,
experience of the emergency medical team, situation at the scene,
transport times, air and ground rescue
Communication in the team: Site of anesthesia induction, clear allocation of
tasks, selection of medicines, other important notes and agreements
Optimal positioning: "Light, space, warmth" concept, ideal for upper body
elevation in the ambulance (caution: not with spinal immobilization or
hemodynamicallyunstablepatients),headin"snifng"position.
Pre-oxygenation:
For a spontaneously breathing
patient, at least 3-4 min O
2
insufationwith12-15l/minvia
a face mask with reservoir or
demand valve, if applicable, NIV or
mask ventilation.
parallel
Standardized preparation:
Anaesthesia and emergency medications,
respiratory alternatives, suction,
capnography.
Monitoring: Pulse oximetry,
ECG, blood pressure, capnography.
Two peripheral venous accesses: In case of
difcult puncture conditions, consider in
-
traosseous puncture in a time-critical manner.
Rapid Sequence Induction (RSI)
Continuous monitoring: Anesthesia management and monitoring