从患者角度看快速序贯插管。
Rapid Sequence Intubation from the Patient's Perspective.
机构信息
Keck School of Medicine of the University of Southern California, Los Angeles, California.
出版信息
West J Emerg Med. 2011 Nov;12(4):365-7. doi: 10.5811/westjem.2010.11.1922.
INTRODUCTION
This study assesses the efficacy of the rapid sequence intubation (RSI) protocol in preventing patient recollection of resuscitative events and patient discomfort during intubation, as subjectively determined by the patient.
METHODS
This was a prospective study of all patients intubated at Los Angeles County, University of Southern California Medical Center from July 2009 to January 2010. Extubated patients were interviewed using a standard questionnaire and data collection tool.
RESULTS
Of 211 airway codes, 201 were excluded due to death before extubation, transfer, or persistent vegetative state, leaving 10 awake, alert subjects who were interviewed regarding their recollection of the RSI and resuscitation. Five had recollection of the event. Most patients recalling RSI described the event as painful or uncomfortable despite receiving the recommended doses of sedation/induction agents.
CONCLUSION
In this cohort of 10 patients intubated using typical agents, 5 remembered some details of their intubation and 2 described pain that was 10/10 on a verbal pain scale. Further work is indicated to ensure that the medications used during this procedure provide the appropriate sedation and amnesia.
简介
本研究评估了快速序贯插管（RSI）方案在预防患者对复苏事件和插管期间不适的回忆方面的效果，这是通过患者的主观感受来确定的。
方法
这是一项对 2009 年 7 月至 2010 年 1 月期间在洛杉矶县南加州大学医疗中心插管的所有患者进行的前瞻性研究。使用标准问卷和数据收集工具对拔管后的患者进行访谈。
结果
在 211 次气道代码中，由于在拔管前死亡、转移或持续植物状态，有 201 次被排除在外，留下 10 名清醒、警觉的患者，对他们对 RSI 和复苏的回忆进行了访谈。有 5 人记得该事件。尽管接受了推荐剂量的镇静/诱导药物，但大多数回忆起 RSI 的患者都将该事件描述为疼痛或不适。
结论
在本研究的 10 名使用典型药物插管的患者中，有 5 名患者回忆起了插管的一些细节，有 2 名患者描述的疼痛程度为 10/10 的口述疼痛量表。需要进一步的研究以确保在该程序中使用的药物能提供适当的镇静和遗忘。
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