Rose W D, Anderson L D, Edmond S A
West Virginia University Health Sciences Center, Morgantown 26506.
Air Med J. 1994 Nov-Dec;13(11-12):475-8. doi: 10.1016/S1067-991X(05)80289-5.
After finding the success rate of intubations in our air medical program to be less than optimal (with a success rate of only 73%), a protocol for increased doses of sedatives and neuromuscular blocking (NMB) agents was developed for field use by flight nurses and paramedics.
A retrospective chart review was performed for 100 intubations before and 100 intubations after establishment of this protocol.
Success rate of intubation increased from 73% to 96%, which was statistically significant (p < 0.01). No difference existed between the two groups with regard to age, gender, Glasgow Coma Scale scores, nature of injury, route of intubation, number of attempts or percent intubated. Two patients (2%) became bradycardic using the new protocol.
Our results suggest that protocols including sedatives and NMB agents can be used safely and effectively by an appropriately trained air medical team of nurses and paramedics and may improve patient care.
在发现我们空中医疗项目的插管成功率不理想（成功率仅为73%）后，制定了一项增加镇静剂和神经肌肉阻滞剂（NMB）剂量的方案，供飞行护士和护理人员在现场使用。
对该方案制定前的100例插管和制定后的100例插管进行回顾性病历审查。
插管成功率从73%提高到96%，具有统计学意义（p < 0.01）。两组在年龄、性别、格拉斯哥昏迷量表评分、损伤性质、插管途径、尝试次数或插管百分比方面无差异。使用新方案时有两名患者（2%）出现心动过缓。
我们的结果表明，经过适当培训的空中医疗护士和护理人员团队可以安全有效地使用包括镇静剂和NMB药物的方案，并且可能改善患者护理。
