Mollalign Mamaru, Gebreegzi Amare Hailekiros, Getinet Habtamu, Adem Seid
University of Gondar, Gondar, Ethiopia.
Anesthesiol Res Pract. 2019 Sep 22;2019:6842092. doi: 10.1155/2019/6842092. eCollection 2019.
In patients who are liable to the risk of pulmonary aspiration, airway control is the primary and first concern for the anesthetists both in emergency and elective surgical procedures. Rapid sequence induction is universally required in any occasion of emergent endotracheal intubation needed for unfasted patients or patients' fasting status is unknown.
institutional-based prospective observational study was conducted from December 2017 to January 2018 in all elective and emergency adult or pediatric patients with a risk of pulmonary aspiration who were operated under general anesthesia with rapid sequence induction and intubation during the audit period.
A total of 35 patients were operated during the study period. Of these, 31 (88.57%) patients were adults and 4 (11.43%) patients were pediatrics. Most of the patients were emergency (29 (82.857%)), and the rest were elective (6 (17.142%)).
Most anesthetists were good at preparing all available monitoring and drugs, making sure that IV line is well-functioning, preparing suction with a suction machine, preoxygenation, application of cricoid pressure, and checking the position of the ETT after intubation was performed. Preparing difficult airway equipment during planning of rapid sequence induction and intubation, giving roles and told to proceed their assigned role for the team, attempt to ventilate with a small tidal volume, and routine use of bougie or stylet to increase the chance of success of intubation needed improvement.
在有肺误吸风险的患者中，无论是急诊还是择期手术，气道控制都是麻醉医生首要和最关注的问题。对于未禁食或禁食状态不明的患者，在任何需要紧急气管插管的情况下，都普遍需要采用快速顺序诱导。
2017年12月至2018年1月，对所有有肺误吸风险、在审计期间接受全身麻醉并采用快速顺序诱导和插管的择期和急诊成年或儿科患者进行了基于机构的前瞻性观察研究。
研究期间共对35例患者进行了手术。其中，31例（88.57%）为成人，4例（11.43%）为儿科患者。大多数患者为急诊患者（29例，82.857%），其余为择期患者（6例，17.142%）。
大多数麻醉医生擅长准备所有可用的监测设备和药物，确保静脉通路功能良好，准备好吸引器进行吸引，进行预充氧，施加环状软骨压迫，并在插管后检查气管导管的位置。在快速顺序诱导和插管计划过程中准备困难气道设备，为团队分配角色并告知其执行指定角色，尝试用小潮气量通气，以及常规使用探条或管芯以增加插管成功率等方面需要改进。
