Pointer J E
Emergency Medical Service District, Alameda County, California, Oakland.
J Emerg Med. 1988 Nov-Dec;6(6):505-9. doi: 10.1016/0736-4679(88)90409-x.
Paramedics intubated 358 of 383 (93.5%) patients over a nine-month period. There were 85 survivors. The intubators used the curved-blade laryngoscope in 304 patients (79.5%). Two of 25 (8.0%) patients who were not successfully intubated lived; 83 of 358 (23.2%) successfully intubated patients survived. Clinically significant complications occurred in 32 patients (8.9%) who were successfully intubated. Paramedics encountered adverse conditions in 126 patients (32.9%). Presenting cardiac rhythm was recorded. There were no significant differences in intubation success rate between survivors and nonsurvivors or as a function of cardiac rhythm. This retrospective study further documents the ability of paramedics to successfully perform endotracheal intubation. The high success rate supports training with live subjects. Further studies of cause and impact of complications, correlation of success with increased survival, and alternative techniques are essential for effective EMS system medical control.
在九个月的时间里,护理人员为383名患者中的358名(93.5%)进行了气管插管。有85名幸存者。插管人员在304名患者(79.5%)中使用了弯叶片喉镜。25名插管未成功的患者中有2名(8.0%)存活;358名插管成功的患者中有83名(23.2%)存活。32名(8.9%)插管成功的患者出现了具有临床意义的并发症。护理人员在126名患者(32.9%)中遇到了不利情况。记录了患者的初始心律。幸存者和非幸存者之间的插管成功率或作为心律函数的插管成功率没有显著差异。这项回顾性研究进一步证明了护理人员成功进行气管插管的能力。高成功率支持对活体受试者进行培训。对并发症的原因和影响、成功与生存率提高的相关性以及替代技术进行进一步研究对于有效的紧急医疗服务系统医疗控制至关重要。