空气医学儿科快速序列输管的描述性分析:成功和机遇
Daniel P Davis1, Kira Chandran2, Jennifer Noce3
1Logan Health, Division of EMS, Kalispell, MT; Air Methods Corporation, Greenwood Village, CO.
Air medical journal
|May 31, 2024
概括
空中医务人员在儿科快速序列输管 (RSI) 中取得了很高的成功率. 年龄较小的儿童的成功率和设备利用率较低,这表明需要改进氧化前和技术的领域.
科学领域:
- 紧急医疗 紧急医疗
- 儿科重症监护中心儿童重症监护中心
- 空中医疗服务 航空医疗服务
背景情况:
- 先进的气道管理,包括快速序列输管 (RSI),在复苏中至关重要.
- 儿童气道管理数据,特别是来自紧急空气医疗设置的数据,由于程序不频繁而有限.
研究的目的:
- 在一个大型的空中医疗数据库中记录儿科RSI的经验.
- 确定改善儿科呼吸道管理结果的机会.
主要方法:
- 航空医务人员 (2015-2019) 对1,091名经历RSI的儿科患者 (<18岁) 的分析 (2015-2019).
- 患者被分为0-2,3-8岁和9-17岁的年龄分组.
- 关键结果包括整体输管成功,第一次尝试成功和第一次尝试成功没有脱; 氧化前方法和脱率也被检查.
主要成果:
- 总体而言,儿科RSI的成功率为98%,在第一次尝试时为91%,没有脱时为87%.
- 当氧化前SpO2 <97%时,输管成功显著下降.
- 年轻的患者 (0-2岁) 初始SPO2较低,首次尝试成功率较低,PPV,视频喉腔镜或布吉的使用较少.
结论:
- 空中医学儿科RSI的成功率很高.
- 在氧化前过程中更高的SpO2目标可能是有益的.
- 年轻的儿科患者需要量身定制的方法,观察到较低的先进气道辅助使用率.
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