US Acute Care Solutions, Canton, OH; Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA.
Heller School for Social Policy and Management, Brandeis University, Waltham, MA.
Ann Emerg Med. 2019 Dec;74(6):786-794. doi: 10.1016/j.annemergmed.2019.04.025. Epub 2019 Jun 24.
Although intubation is a commonly discussed procedure in emergency medicine, the number of opportunities for emergency physicians to perform it is unknown. We determine the frequency of intubation performed by emergency physicians in a national emergency medicine group.
Using data from a national emergency medicine group (135 emergency departments [EDs] in 19 states, 2010 to 2016), we determined intubation incidence per physician, including intubations per year, intubations per 100 clinical hours, and intubations per 1,000 ED patient visits. We report medians and interquartile ranges (IQRs) for estimated intubation rates among emergency physicians working in general EDs (those treating mixed adult and pediatric populations).
We analyzed 53,904 intubations performed by 2,108 emergency physicians in general EDs (53,265 intubations) and pediatric EDs (639 intubations). Intubation incidence varied among general ED emergency physicians (median 10 intubations per year; IQR 5 to 17; minimum 0, maximum 109). Approximately 5% of emergency physicians did not perform any intubations in a given year. During the study, 24.1% of general ED emergency physicians performed fewer than 5 intubations per year (range 21.2% in 2010 to 25.7% in 2016). Emergency physicians working in general EDs performed a median of 0.7 intubations per 100 clinical hours (IQR 0.3 to 1.1) and 2.7 intubations per 1,000 ED patient visits (IQR 1.2 to 4.6).
These findings provide insights into the frequency with which emergency physicians perform intubations.
虽然气管插管是急诊医学中经常讨论的程序,但急诊医生进行该操作的机会数量尚不清楚。我们确定了全国急诊医学组中急诊医生进行气管插管的频率。
利用来自全国急诊医学组的数据(19 个州的 135 个急诊部,2010 年至 2016 年),我们确定了每位医生的插管发生率,包括每年插管次数、每 100 个临床小时插管次数和每 1000 次急诊就诊插管次数。我们报告了在普通急诊部(治疗混合成人和儿科患者的部门)工作的急诊医生中估计的插管率的中位数和四分位距(IQR)。
我们分析了 53265 次在普通急诊部(53904 次插管)和儿科急诊部(639 次插管)进行的由 2108 名急诊医生进行的插管。普通急诊部的急诊医生插管发生率存在差异(中位数 10 次/年;IQR 5 至 17;最小值 0,最大值 109)。大约 5%的急诊医生在特定年份没有进行任何插管。在研究期间,24.1%的普通急诊部急诊医生每年进行的插管次数少于 5 次(范围从 2010 年的 21.2%到 2016 年的 25.7%)。在普通急诊部工作的急诊医生每 100 个临床小时的中位数插管次数为 0.7 次(IQR 0.3 至 1.1),每 1000 次急诊就诊的中位数插管次数为 2.7 次(IQR 1.2 至 4.6)。
这些发现提供了关于急诊医生进行插管的频率的深入了解。