Steuerwald Michael T, Braude Darren A, Petersen Timothy R, Peterson Kari, Torres Michael A
UW Med Flight, 600 Highland Ave, Madison, WI 53792; Department of Emergency Medicine, University of Wisconsin-Madison, 800 University Bay Drive, Suite 310, Mail Code 9123, Madison, WI 53705.
Lifeguard Air Emergency Services, 2505 Clark Carr Loop SE, Albuquerque, NM 87106; Department of Emergency Medicine, University of New Mexico, MSC11 6025, Albuquerque, NM 87131; Department of Anesthesiology, University of New Mexico, MSC 10 6000, 2211 Lomas Blvd NE, Albuquerque, NM 87106.
Air Med J. 2018 Jul-Aug;37(4):240-243. doi: 10.1016/j.amj.2018.04.004. Epub 2018 May 9.
There has been a shift from endotracheal intubation (ETI) toward extraglottic devices (EGDs) for prehospital airway management. A concern exists that this may lead to more frequent cases of aspiration.
This was a retrospective study using a prehospital quality assurance database. Patients were assigned to groups based on the method that ultimately managed their airways (EGD or ETI). Cases with documented blood/emesis obscuring the airway were considered inevitable aspiration cases and excluded. Aspiration was defined by the radiology report within 48 hours.
A total of 104 EGD and 152 ETI patients were identified. Aspiration data were available for 67 EGD and 94 ETI cases. Of those, 8 EGD and 3 ETI cases had blood/emesis obscuring the airway and were excluded as planned. After exclusions, there were 5 EGD and 11 ETI cases in which aspiration was later diagnosed (EGD aspiration rate = 8%, ETI aspiration rate = 12%; χ: P = .359; relative risk = .841; 95% confidence interval, .329-2.152).
In this small quality assurance database, aspiration rates were not significantly different for prehospital patients managed with an EGD versus ETI.
在院前气道管理中，已出现从气管内插管（ETI）向声门上装置（EGD）的转变。有人担心这可能导致误吸病例更为频繁。
这是一项使用院前质量保证数据库的回顾性研究。根据最终管理患者气道的方法（EGD或ETI）将患者分组。气道被血液/呕吐物遮挡并有记录的病例被视为不可避免的误吸病例并被排除。误吸由48小时内的放射学报告定义。
共识别出104例使用EGD的患者和152例使用ETI的患者。有67例使用EGD和94例使用ETI的病例可获得误吸数据。其中，8例使用EGD和3例使用ETI的病例气道被血液/呕吐物遮挡，按计划被排除。排除后，有5例使用EGD和11例使用ETI的病例后来被诊断为误吸（EGD误吸率=8%，ETI误吸率=12%；χ：P=.359；相对风险=.841；95%置信区间，.329 - 2.152）。
在这个小型质量保证数据库中，使用EGD与ETI管理的院前患者误吸率没有显著差异。
