Adams K, Scott R, Perkin R M, Langga L
Department of Respiratory Care, Loma Linda University Children's Hospital, California 92354, USA.
Pediatr Emerg Care. 2000 Feb;16(1):5-8. doi: 10.1097/00006565-200002000-00002.
To compare intubation skill level and success rate between interfacility transport team members.
Prospective collection of data.
University affiliated children's hospital interfacility transport team.
One hundred thirty-two pediatric patients (age range 4 days to 11 years) intubated prior to transport by a specialized team.
None.
Prospective data was gathered from June 1992 November 1996. In 3616 transports reviewed, 132 intubations were performed by the team at the referring facility. Patient ages ranged from 4 days to 11 years with a mean age of 23 months. We compared resident physicians and respiratory care practitioners (RCPs) to a standard threshold of 1 attempt per successful intubation. An attempt was defined as passage of the endotracheal tube into the oropharynx in an effort to pass it through the vocal cords. Patients were sedated and paralyzed for the procedures. The physicians were 2nd and 3rd year pediatric or emergency medicine residents. They received intubation training in Pediatric Advanced Life Support (PALS), Neonatal Resuscitation Program (NRP), and during rotations through neonatal and pediatric intensive care units. RCPs had an average of 3.5 years of experience overall on the transport team. They received training primarily on mannequins and written tests while in school. They were certified in PALS and NRP and required to participate in annual skill laboratories, which consisted of mannequin intubations and a written examination.
The results showed the RCPs to have greater overall success as well as greater success of intubation on first attempt compared to the resident physicians.
In our experience, RCPs on the interfacility transport team were very successful in performing endotracheal intubations and were more successful than resident physicians. RCPs are established members of not only the transport team, but also the intensive care units and, therefore, should be considered qualified to routinely perform endotracheal intubations in those settings as well.
比较医疗机构间转运团队成员的插管技能水平和成功率。
前瞻性数据收集。
大学附属医院的儿童医疗机构间转运团队。
132名儿科患者（年龄范围4天至11岁），在由专业团队转运前进行了插管。
无。
前瞻性数据收集自1992年6月至1996年11月。在回顾的3616次转运中，团队在转诊机构进行了132次插管。患者年龄从4天至11岁不等，平均年龄为23个月。我们将住院医师和呼吸治疗师（RCP）与每次成功插管1次的标准阈值进行比较。一次尝试定义为将气管内导管插入口咽以试图通过声带。患者在操作过程中接受镇静和麻痹。医生为儿科或急诊医学专业的二年级和三年级住院医师。他们接受了儿科高级生命支持（PALS）、新生儿复苏计划（NRP）以及在新生儿和儿科重症监护病房轮转期间的插管培训。RCP在转运团队的总体平均经验为3.5年。他们在学校主要接受模拟人体训练和笔试。他们获得了PALS和NRP认证，并要求参加年度技能实验室，其中包括模拟人体插管和笔试。
结果显示，与住院医师相比，RCP的总体成功率更高，首次插管成功率也更高。
根据我们的经验，医疗机构间转运团队中的RCP在进行气管插管方面非常成功，并且比住院医师更成功。RCP不仅是转运团队的既定成员，也是重症监护病房的成员，因此，也应被视为有资格在这些环境中常规进行气管插管。
