急性會厭炎於緊急呼吸道處置之注意義務【寰宇醫事裁判】 試閱
Duty of Care for Emergent Airway Management during Acute Epiglottitis
原告X1罹患急性會厭炎，於被告Y醫院接受緊急插管處置。惟被告醫師刺入第2∼3氣管環間位置，而非環甲膜切開術應刺入之環甲膜；且手術期間原告X1自行拔管而出血，被告醫師在未觀察清楚聲門與喉蓋位置，仍盲目插管。此時原告X1呼吸心跳停止，經急救後因缺氧性病變陷入植物人狀態。原告X1與其父母向被告Y醫院請求損害賠償。法院認為本件並無施用經皮氣管切開術的特殊狀況，且被告醫師並不熟悉該手術，故有過失；若被告醫師正確施用環甲膜切開術，即使X1自行拔管也不會失血過多，因此被告醫師之過失與X1之損害間有因果關係。
Plaintiff X1 suffered from acute epiglottitis and underwent emergency intubation at hospital Y as a defendant. However, the defendant physician inserted the tube between the 2nd and 3rd tracheal rings instead of the cricothyroid membrane, which should have been inserted during the cricothyroidotomy; and during the operation, plaintiff X1 pulled out the tube by himself and bled, and the defendant doctor inserted the tube blindly without clearly observing the position of the vocal cords and the laryngeal lid. At that time, Plaintiff X1’s respiration and heartbeat stopped, and after the first aid, he fell into a vegetative state due to hypoxic lesions. Plaintiff X1 and his parents sought damage from defendant Y. The court held that there was no special circumstance in which the percutaneous tracheotomy was performed and the defendant physician was unfamiliar with the procedure and therefore negligent; if the defendant physician had performed the cricothyrotomy correctly, X1 would not have lost too much blood even if he had extubated himself, and therefore there was a causal relationship between the defendant physician negligence and X1’s injuries.
133-141
