University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, 08901, USA.
Am J Emerg Med. 2011 Jul;29(6):590-3. doi: 10.1016/j.ajem.2009.12.022. Epub 2010 Apr 2.
Several studies have been published in the literature about intubation methods, but little is available on intubation equipment used in this setting. This is the first prehospital comparison of disposable plastic vs disposable stainless steel laryngoscope blades used by paramedics.
The objective of this study was to compare prehospital intubation success rates on first attempt and overall number of attempts to obtain intubations using disposable plastic laryngoscopes blades vs disposable stainless steel laryngoscope blades.
A retrospective prehospital cohort study was conducted during two 3-year periods. Two-way contingency table and χ(2) test were conducted to determine if there was a difference between the 2 types of blades. A proportional odds model with calculated 95% confidence interval (CI) and odd ratios were then calculated.
A total of 2472 paramedic intubations were recorded over the 6-year period. The stainless steel single-use blades had a first attempt success rate of 88.9% vs 78.5% with plastic blades (P = .01; odds ratio, 1.94; 95% CI, 1.17-3.41). The stainless steel single-use laryngoscope blade had a lower number of attempts to successful intubation than the plastic blade (88.8% vs 74.3%, respectively) (P < .01; odds ratio, 1.64; 95% CI, 1.34-2.00).
In the prehospital setting, stainless steel disposable blades were superior to plastic disposable blades in first attempt and overall number of attempts to intubation. Until further research is done, we recommend use of stainless steel blades for intubations in the prehospital setting by paramedics.
已有多篇关于插管方法的文献发表，但在该领域中，用于插管的设备相关内容却很少。这是首次对急救人员使用的一次性塑料和一次性不锈钢喉镜叶片进行的院前比较。
本研究的目的是比较一次性塑料喉镜叶片与一次性不锈钢喉镜叶片在首次尝试和总体插管尝试次数方面的院前插管成功率。
进行了一项回顾性的院前队列研究，研究期间为两个 3 年时间段。采用双向列联表和 χ(2)检验来确定这两种叶片之间是否存在差异。然后使用比例优势模型计算并得出 95%置信区间（CI）和优势比。
在 6 年期间共记录了 2472 次由急救人员进行的插管。不锈钢一次性使用叶片的首次尝试成功率为 88.9%，而塑料叶片为 78.5%（P =.01；优势比，1.94；95%CI，1.17-3.41）。不锈钢一次性使用喉镜叶片成功插管的尝试次数少于塑料叶片（分别为 88.8%和 74.3%）（P <.01；优势比，1.64；95%CI，1.34-2.00）。
在院前环境中，不锈钢一次性使用叶片在首次尝试和总体插管尝试次数方面均优于塑料一次性使用叶片。在进一步研究完成之前，我们建议急救人员在院前环境中使用不锈钢叶片进行插管。
