Wang Henry E, Kupas Douglas F, Hostler David, Cooney Robert, Yealy Donald M, Lave Judith R
Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Crit Care Med. 2005 Aug;33(8):1718-21. doi: 10.1097/01.ccm.0000171208.07895.2a.
Out-of-hospital rescuers likely need regular clinical experience to perform endotracheal intubation (ETI) in a safe and effective manner. We sought to determine the frequency of ETI performed by individual out-of-hospital rescuers.
Analysis of an administrative database of all emergency medical services (EMS) patient care reports in Pennsylvania.
Commonwealth of Pennsylvania from January 1 to December 31, 2003.
EMS advanced life support rescuers (paramedics, prehospital nurses, and EMS physicians) who reported at least one patient contact during the study period.
None.
We calculated individual rescuer ETI frequency and opportunity. We evaluated relationships between ETI frequency and the number of patient contacts. We also examined the relationship with practice setting (air medical vs. ground rescuers and urban vs. rural rescuers).
In 1,544,791 patient care reports, 11,484 ETIs were reported by 5,245 out-of-hospital rescuers. The median ETI frequency was one (interquartile range, 0-3; range, 0-23). Of 5,245 rescuers, >67% (3,551) performed two or fewer ETIs, and >39% (2,054) rescuers did not perform any ETIs. The median number of ETI opportunities was three (interquartile range, 0-6; range, 0-76). ETI frequency was associated with patient volume (Spearman's rho = 0.67) and was higher for air medical (p = .006) and urban (p < .0001) rescuers. ETI frequency was not associated with response (Spearman's rho = -0.01) or transport (Spearman's rho = -0.06) times.
Out-of-hospital ETI, an important and difficult resuscitation intervention, is an uncommon event for most rescuers.
院外救援人员可能需要定期的临床经验，才能安全有效地进行气管插管（ETI）。我们试图确定个体院外救援人员进行ETI的频率。
对宾夕法尼亚州所有紧急医疗服务（EMS）患者护理报告的管理数据库进行分析。
2003年1月1日至12月31日的宾夕法尼亚州。
在研究期间报告至少有一次患者接触的EMS高级生命支持救援人员（护理人员、院前护士和EMS医生）。
无。
我们计算了个体救援人员的ETI频率和机会。我们评估了ETI频率与患者接触次数之间的关系。我们还研究了与实践环境（空中医疗救援人员与地面救援人员以及城市救援人员与农村救援人员）的关系。
在1,544,791份患者护理报告中，5,245名院外救援人员报告了11,484次ETI。ETI频率的中位数为1次（四分位间距，0 - 3；范围，0 - 23）。在5,245名救援人员中，超过67%（3,551名）进行了两次或更少的ETI，超过39%（2,054名）救援人员未进行任何ETI。ETI机会的中位数为3次（四分位间距，0 - 6；范围，0 - 76）。ETI频率与患者数量相关（斯皮尔曼相关系数=0.67），空中医疗救援人员（p = 0.006）和城市救援人员（p < 0.0001）的ETI频率更高。ETI频率与响应时间（斯皮尔曼相关系数= - 0.01）或转运时间（斯皮尔曼相关系数= - 0.06）无关。
院外ETI是一项重要且困难的复苏干预措施，对大多数救援人员来说是不常见的事件。
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