Stassen Willem, Lithgow Alastair, Wylie Craig, Stein Christopher
Department of Emergency Medical Care, University of Johannesburg, South Africa.
Afr J Emerg Med. 2018 Dec;8(4):140-144. doi: 10.1016/j.afjem.2018.07.002. Epub 2018 Jul 26.
Helicopter Emergency Medical Services (HEMS) exists to supplement the operations of ground-based emergency care providers, mainly in high acuity cases. One of the important procedures frequently carried out by HEMS personnel is endotracheal intubation. Several HEMS providers exist in South Africa, with a mix of advanced life support personnel, however intubation success rates and adverse events have not been described in any local HEMS operation.
This was a retrospective chart review of intubation-related data collected by a HEMS operation based in Johannesburg over a 16-month period. First-pass and overall success rates were described, in addition to perceived airway difficulty, adverse events and other data.
Of the 49 cases recorded in the study period, one was excluded leaving 48 cases for analysis. Most cases (n = 34, 71%) involved young male trauma patients who were intubated with rapid sequence intubation. The first pass success rate was 79% (n = 38) with an overall success rate of 98% (n = 47). At least one factor suggesting airway difficulty was present in 29% (n = 14) of cases, with most perceived airway difficulty related to the high prevalence of trauma cases. At least one adverse event occurred in 27% (n = 13) of cases with hypoxaemia, hypotension and bradycardia most prevalent.
In this small sample of South African HEMS intubation cases, we found overall and first-pass success rates comparable to those reported in similar contexts.
直升机紧急医疗服务（HEMS）旨在辅助地面急救人员开展工作，主要针对高急症病例。HEMS人员经常执行的重要操作之一是气管插管。南非有多家HEMS服务提供商，配备了一批高级生命支持人员，但尚无任何本地HEMS操作中气管插管成功率及不良事件的相关描述。
这是一项对约翰内斯堡一家HEMS机构在16个月内收集的插管相关数据进行的回顾性图表审查。除了感知到的气道困难、不良事件及其他数据外，还描述了首次插管成功率和总体成功率。
在研究期间记录的49例病例中，排除1例，剩余48例用于分析。大多数病例（n = 34，71%）为年轻男性创伤患者，采用快速顺序插管法进行插管。首次插管成功率为79%（n = 38），总体成功率为98%（n = 47）。29%（n = 14）的病例中至少存在一个提示气道困难的因素，大多数感知到的气道困难与创伤病例的高发生率有关。27%（n = 13）的病例发生了至少一种不良事件，其中低氧血症、低血压和心动过缓最为常见。
在这个南非HEMS插管病例的小样本中，我们发现总体成功率和首次插管成功率与类似情况下报告的结果相当。
