van Poelgeest A, Melis R J F, Ritmeijer C, Olde Rikkert M G M
AIOS klinische geriatrie, Kenniscentrum Geriatrie, MC St Radboud, Nijmegen.
Tijdschr Gerontol Geriatr. 2006 Sep;37(4):147-51.
It is unknown how often choking occurs in geriatric wards and in nursing homes and what the treatment and outcomes are in regular practice. A questionnaire was sent to Dutch geriatricians (N = 130), nursing home physicians (N = 130), and trainees for these disciplines (N = 215), in order to gain information about the experience, practice and competence of physicians in choking in geriatric and nursing home patients. We also analysed to what extent geriatric and nursing home wards were prepared for accurate handling of choking. The response rate was 30%. More than half of the responders had experienced an episode of food choking at least once in the past five years. The mortality rate in the reported cases was high (30%). The majority of the patients who died of choking had not received the Heimlich-manoeuvre. Physicians who had attended resuscitation training long ago felt as competent to manage a choking episode as physicians that had recently attended resuscitation training. Of all geriatric wards and nursing homes, the majority lacked a guideline on how to handle in acute food choking. Geriatric wards and nursing homes do not seem to be well prepared for acute food choking in several aspects. Despite methodological shortcomings of this study, the results underline the necessity of clarification of the terms used, and development and implementation of guidelines for this important problem.
目前尚不清楚在老年病房和养老院中窒息发生的频率如何，以及常规实践中的治疗方法和结果如何。我们向荷兰的老年病医生（N = 130）、养老院医生（N = 130）以及这些学科的实习生（N = 215）发放了一份问卷，以获取有关医生在处理老年患者和养老院患者窒息方面的经验、实践和能力的信息。我们还分析了老年病房和养老院在准确处理窒息方面的准备程度。回复率为30%。超过一半的受访者在过去五年中至少经历过一次食物窒息事件。报告病例中的死亡率很高（30%）。大多数因窒息死亡的患者未接受海姆立克急救法。很久以前参加过复苏培训的医生感觉在处理窒息事件方面与最近参加过复苏培训的医生一样有能力。在所有老年病房和养老院中，大多数缺乏关于如何处理急性食物窒息的指南。老年病房和养老院在几个方面似乎对急性食物窒息准备不足。尽管本研究存在方法学上的缺陷，但结果强调了澄清所用术语以及针对这一重要问题制定和实施指南的必要性。
