在COVID-19期间医院前协议修改对第一通输管成功率的影响
Abagayle E Bierowski1,2,3, Paul C Comber2,3, Alexander Kuc2,3
1Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PennsylvaniaUSA.
Prehospital and disaster medicine
|April 2, 2025
概括
随着COVID-19的流行,气管管道输管 (TI) 的数量减少,第一通 TI 成功率下降. 机构必须使用模拟和培训,以保持高级气道管理的熟练程度.
科学领域:
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
- 公共卫生 公共卫生
背景情况:
- COVID-19大流行改变了紧急医疗服务 (EMS) 协议,特别是那些增加空气中暴露风险的方案,如气管输管 (TI).
- 高级生命支持 (ALS) 提供者在2020年优先考虑了上气道 (SGA) 的使用,而TI很少进行.
研究的目的:
- 评估与流行病相关的协议变更对首次通过TI成功率的临床影响.
- 评估对初始先进气道安置成功的整体影响.
主要方法:
- 需要先进的气道放置的ALS遭遇的回顾性图表审查 (2019年1月 - 2021年6月).
- 来自一个城市EMS机构的452个医院外先进气道安置的分析.
- 使用了描述性统计和千平方测试,统计学意义的P<0.05.
主要成果:
- 与2019年相比,TI尝试在2020年显著下降 (P < .001).
- 首次通过TI的成功率在2021年下降 (61.1%) 与2019年 (78.8%;P = .047).
- 与2019年 (58.8%) 相比,SGA使用在2020年 (91.2%) 和2021年 (70.7%) 显著增加. 总体而言,首次尝试先进气道的成功率在2020年上升,但在2021年下降.
结论:
- 在大流行期间减少TI暴露可能导致2021年首次通过TI成功率下降.
- 电子商务管理机构需要模拟和持续教育,以保持提供商在IT方面的熟练程度.
- 保持心理运动技能至关重要,特别是当协议变化限制现场实践时.
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