在视频喉腔镜检查期间使用初始直接喉腔镜的医院前气管输管技术的评估:随机对照模拟试验
Cédric Cibotto1,2,3, Mathieu Pasquier4,5, Nicolas Beysard4,5
1Division of Anaesthesiology, Department of Acute Care Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, 1205, Switzerland. cedric.cibotto@hug.ch.
BMC emergency medicine
|July 2, 2025
概括
对于新手提供者来说,在视频喉科镜 (DL-VL序列) 之前使用直接喉科镜并没有改善模拟医院前环境中的输管时间或通风时间. 无限制的视频喉科镜的使用对于气管管道输管更快.
科学领域:
- 紧急医疗 紧急医疗
- 医疗模拟 医疗模拟
- 航空航道管理的管理.
背景情况:
- 在危急病患者的预医院气管输管存在挑战.
- 视频喉科镜可提供更好的喉视觉,但可能会阻碍新手提供者通过促进2D超过3D空间理解.
- 直接可视化可能会增强解剖学的理解.
研究的目的:
- 为了比较无限制视频喉科镜与直接喉科镜到视频喉科镜 (DL-VL) 序列在模拟医院前环境中的新手提供者中对气管管道输液时间的影响.
主要方法:
- 一个模拟的随机对照优越性试验,涉及新手提供者 (医学学生/初级住院医生,输管次数低于10次).
- 参与者被随机分配到无限制的视频喉腔镜使用或DL-VL序列 (屏幕使用前的初始直接喉腔镜).
- 在模拟的医院前环境中,在一个高保真模型上进行了输入管,难度水平不断增加.
主要成果:
- 与DL-VL序列 (27±11秒;p < 0.001) 相比,无限制的视频喉腔镜 (22±8秒) 的输管时间显著缩短.
- 在不受限制的视频喉科镜组中,通风时间也较短 (37±9秒与41±11秒相比; p = 0.008).
- 第一通成功率 (89%对81%) 和平均输管尝试在各组之间是相似的.
结论:
- 在模拟的医院前环境中,直接喉镜到视频喉镜序列并没有改善新手提供者的输入管或通风时间.
- 不受限制的视频喉腔镜使用导致了这个新手提供者队列中更快的气管管道输液时间.
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