Stone C K, Thomas S H
University of Kentucky Medical Center, Lexington 40536.
Air Med J. 1994 Aug;13(8):319-21. doi: 10.1016/S1067-991X(05)80337-2.
Patients transported by helicopter often require advanced airway management. The purpose of this study was to determine whether or not the in-flight environment of air medical transport in a BO-105 helicopter impairs the ability of flight nurses to perform oral endotracheal intubation.
The study was conducted in an MBB BO-105 helicopter.
Flight nurses performed three manikin intubations in each of the two study environments: on an emergency department stretcher and in-flight in the BO-105 helicopter.
The mean time required for in-flight intubation (25.9 +/- 10.9 seconds) was significantly longer than the corresponding time (13.2 +/- 2.8 seconds) required for intubation in the control setting (ANOVA, F = 38.7, p < .001). All intubations performed in the control setting were placed correctly in the trachea; there were two (6.7%) esophageal intubations in the in-flight setting. The difference in appropriate endotracheal intubation between the two settings was not significant (chi 2 = 0.3; p > 0.05).
Oral endotracheal intubation in the in-flight setting of the BO-105 helicopter takes approximately twice as long as intubation in a ground setting. The results support pre-flight intubation of patients who appear likely to require urgent intubation during air medical transport in the BO-105 helicopter.
通过直升机转运的患者通常需要高级气道管理。本研究的目的是确定在BO - 105直升机空中医疗转运的飞行环境中，飞行护士进行经口气管插管的能力是否会受到损害。
该研究在一架MBB BO - 105直升机上进行。
飞行护士在两种研究环境中分别对人体模型进行三次插管操作：在急诊科担架上和在BO - 105直升机飞行过程中。
飞行中插管所需的平均时间（25.9 +/- 10.9秒）明显长于对照环境中插管所需的相应时间（13.2 +/- 2.8秒）（方差分析，F = 38.7，p <.001）。在对照环境中进行的所有插管均正确插入气管；在飞行环境中有两次（6.7%）食管插管。两种环境中合适的气管插管差异不显著（卡方检验= 0.3；p > 0.05）。
在BO - 105直升机飞行环境中进行经口气管插管所需时间大约是地面环境插管的两倍。研究结果支持对在BO - 105直升机空中医疗转运期间可能需要紧急插管的患者进行飞行前插管。
