在COVID-19大流行期间通过简单和低成本的干预来改善输管成功:一个准实验性研究
Guillermo Jesús Mauro1, Gustavo Armando2, Lorena Natalia Cabillón1
1Servicio de Emergencias, Hospital Interzonal de Agudos San Martín de La Plata, La Plata, Argentina.
Medicina intensiva
|July 16, 2023
概括
一项教育干预显著提高了急诊室输管术的第一通成功率 (FPS). 这种低成本的方法提高了气道管理,取得了与高收入国家相美的结果.
科学领域:
- 紧急医疗 紧急医疗
- 医疗教育 医学教育
- 航空航线管理的管理.
背景情况:
- 在紧急气道输管中,第一通成功率 (FPS) 对患者的结果至关重要.
- 在资源有限的环境中改善FPS带来了独特的挑战.
- 现有的文献往往侧重于高收入国家背景.
研究的目的:
- 在急诊室 (ED) 进行教育干预后,提高第一次通过成功率 (FPS).
- 为了确定与ED中输管试验相关的变量.
- 评估认知辅助器和检查清单对输管性能的影响.
主要方法:
- 在阿根廷的一家公共医院进行了前性准实验性研究.
- 实施了一项教育干预,包括认知辅助工具和输管前检查清单.
- 分析了266名接受输管治疗的患者的数据,比较了干预前后的时间.
主要成果:
- FPS率从干预前组的69.9%显著增加到干预后组的85.3% (p=0.002).
- 低操作员经验,Cormack-Lehane 3级,缺乏培训与更多的输管尝试有关.
- 监测的关键变量包括操作员经验,气道困难预测因素和输管治疗结果.
结论:
- 一个简单的,低成本的教育干预措施有效地提高了紧急气道管理中的FPS率.
- 干预使得ED能够实现与高收入国家报告的FPS率相提并论的FPS率.
- 有针对性的培训和认知辅助是提高输管成功的宝贵工具.
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