Читать книгу Emergency Medical Services - Группа авторов - Страница 527

Deterioration after complete airway obstruction occurs so rapidly that direct medical oversight by phone or radio likely provides minimal value. In cases of partial obstruction, direct medical oversight may provide useful guidance regarding management and receiving hospital options. The most important consideration is to educate EMS personnel to recognize signs and symptoms of partial and complete obstruction. As bystander intervention is essential in treating choking, EMS community outreach and education efforts are equally important. Prevention through activity with regulating authorities can lead to altering or relabeling objects or foods known to be significant choking risks [5, 6, 8, 9].

EMS physician presence at the scene may potentially play a role in select complicated choking cases. Patients with partial airway obstructions may prove to be difficult to manage, requiring a fine balance between supportive care and skilled airway intervention. An on‐scene EMS physician may facilitate selection of optimal treatment strategies. In the event of complete airway obstruction unresolved by basic techniques, an on‐scene EMS physician may be best qualified to perform advanced airway interventions, such as direct or video laryngoscopy and foreign body removal, rapid sequence intubation, or cricothyroidotomy. In all cases, the EMS physician’s value will be greatest if he or she is present at the earliest stages of the event—before complete airway obstruction or anoxic injury.