艰难的气道响应小组在学术紧急部门的结果:一个前性的,多学科的气道管理队列研究
Mustapha O Saheed1, John Varghese2,3, Dang Truong4
1Department of Emergency Medicine, Johns Hopkins Medicine.
概括
在急诊部 (ED) 实施困难气道响应小组 (DART) 改善了第一次试验输管成功,特别是使用先进的气道技术. 这种团队方法在关键呼吸事件期间提高了患者的安全性.
科学领域:
- 紧急医疗 紧急医疗
- 航空航道管理的管理.
- 关键的护理关键的护理
背景情况:
- 首次试图输管对于最小化低氧化和低输液至关重要.
- 对于呼吸损害患者的急诊部 (ED) 基于团队的困难呼吸道管理结果的数据有限.
研究的目的:
- 评估一个已建立的紧急部门困难气道响应小组 (DART) 计划的结果.
主要方法:
- 一项前性观察队列研究在五年内进行,与多学科团队一起实施DART.
- 该研究包括了成人患者,需要在ED中通过DART进行呼吸道管理.
- 关键的结果措施是首次试图输管成功,使用的技术,以及需要手术呼吸道.
主要成果:
- 先进的气道技术 (光纤支气管镜检查,视频喉腔镜检查) 在第一次尝试中取得了76%的成功,而直接喉腔镜检查的成功率为24%.
- 预测首次尝试成功率较低的因素包括难以使用口罩通风,需要心肺复苏和潜在疾病.
- 17名患者需要手术干预,包括6名cricothyroidotomies,没有与呼吸道相关的死亡.
结论:
- 在ED中实施DART计划与改善首次试验输管成功有关.
- 先进的呼吸道技术和有利的患者特征与成功的第一次试验输管术有关.
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