Garza Alex G, Algren D Adam, Gratton Matthew C, Ma O John
Department of Emergency Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64108, USA.
Prehosp Emerg Care. 2005 Apr-Jun;9(2):163-6. doi: 10.1080/10903120590924654.
Pediatric cardiac arrest patients and adult traumatic arrest patients are perceived as more difficult to endotracheally intubate than adult cardiac arrest patients. The study hypothesis was that these populations were at higher risk of endotracheal intubation failure compared with adult cardiac arrest patients and that paramedics would more frequently defer attempts to intubate these patients.
This was a retrospective, observational study analyzing oral endotracheal intubations on pediatric cardiac arrest, adult traumatic arrest, and adult cardiac arrest patients over 66 months. Homogeneity of intubation nonattempt and endotracheal intubation failure was studied with chi-square analysis. Relative risks (RRs) with 95% confidence intervals (CIs) were used to compare pediatric cardiac arrest with adult traumatic arrest with adult cardiac arrest nonattempt rates and endotracheal intubation failure rates.
2,669 oral endotracheal intubations were included. There was a significant difference in intubation nonattempts and intubation failure between the combined pediatric cardiac arrest and adult traumatic arrest groups and the adult cardiac arrest cohort (RR 7.24, 95% CI 5.73, 9.16 for nonattempt; RR = 2.33, 95% CI 1.93, 2.83 for intubation failure). Both groups individually showed significant risk for intubation nonattempt and endotracheal intubation failure compared with adult cardiac arrest, with the pediatric cohort at higher risk for failure and the adult traumatic arrest cohort at higher risk for nonattempt.
There was significant risk of intubation nonattempt and intubation failure in the pediatric cardiac arrest and adult traumatic arrest cohorts compared with the adult cardiac arrest population, with the pediatric cohort being at particularly high risk for intubation failure and the adult traumatic arrest cohort at higher risk for nonattempt.
与成年心脏骤停患者相比，小儿心脏骤停患者和成年创伤性骤停患者被认为更难进行气管插管。研究假设是，与成年心脏骤停患者相比，这些人群气管插管失败的风险更高，并且护理人员会更频繁地推迟对这些患者进行插管的尝试。
这是一项回顾性观察研究，分析了66个月内小儿心脏骤停、成年创伤性骤停和成年心脏骤停患者的经口气管插管情况。采用卡方分析研究插管未尝试和气管插管失败的同质性。使用95%置信区间（CI）的相对风险（RR）来比较小儿心脏骤停与成年创伤性骤停以及成年心脏骤停未尝试率和气管插管失败率。
纳入了2669例经口气管插管。小儿心脏骤停和成年创伤性骤停联合组与成年心脏骤停队列之间在插管未尝试和插管失败方面存在显著差异（未尝试的RR为7.24，95%CI为5.73，9.16；插管失败的RR = 2.33，95%CI为1.93，2.83）。与成年心脏骤停相比，两组各自在插管未尝试和气管插管失败方面均显示出显著风险，小儿队列失败风险更高，成年创伤性骤停队列未尝试风险更高。
与成年心脏骤停人群相比，小儿心脏骤停和成年创伤性骤停队列存在插管未尝试和插管失败的显著风险，小儿队列插管失败风险特别高，成年创伤性骤停队列未尝试风险更高。
