Fogg Toby, Alkhouri Hatem, Vassiliadis John
Emergency Department, Royal North Shore Hospital, Sydney, New South Wales, Australia.
CareFlight, Sydney, New South Wales, Australia.
Emerg Med Australas. 2016 Feb;28(1):27-33. doi: 10.1111/1742-6723.12496. Epub 2015 Nov 11.
We aim to investigate whether a bundle of changes made to the practice of endotracheal intubation in our ED was associated with an improvement in first pass success rate and a reduction in the incidence of complications.
We used a prospective observational study.
The data on 360 patients who were intubated during an 18-month period following the introduction of these changes were compared with our previously published observational data. Success on first attempt at intubation improved 83.4% to 93.9% (P < 0.0001). The proportion of patients with one or more complication fell from 29.0% to 19.4% (P < 0.042). Oesophageal intubation fell from 4.0% to 0.3% (P < 0.001), and there was a non-significant reduction in the rate of desaturation, from 15.6% to 10.9% (P < 0.07).
We have shown that, through the introduction of a bundle of changes that spans the domains of staff training, equipment and practice standardisation, we have made significant improvements in the safety of patients undergoing endotracheal intubation in our ED.
我们旨在调查对急诊科气管插管操作所做的一系列改变是否与首次插管成功率的提高及并发症发生率的降低相关。
我们采用了前瞻性观察研究。
将在引入这些改变后的18个月期间内接受插管的360例患者的数据与我们之前发表的观察数据进行了比较。首次插管尝试的成功率从83.4%提高到了93.9%（P < 0.0001）。出现一种或多种并发症的患者比例从29.0%降至19.4%（P < 0.042）。食管插管率从4.0%降至0.3%（P < 0.001），血氧饱和度降低率从15.6%降至10.9%，差异无统计学意义（P < 0.07）。
我们已经表明，通过引入一系列涵盖人员培训、设备和操作标准化领域的改变，我们显著提高了急诊科接受气管插管患者的安全性。
