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埃塞俄比亚三级护理医院急诊科气管插管成功率的一年回顾性研究。

The Success Rate of Endotracheal Intubation in the Emergency Department of Tertiary Care Hospital in Ethiopia, One-Year Retrospective Study.

作者信息

Zewdie Ayalew, Tagesse Dejene, Alemayehu Selam, Getachew Tesfaye, Sultan Menbeu

机构信息

Department of Emergency Medicine and Critical Care, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Addis Ababa Burn Emergency and Trauma (AaBET) Hospital, Addis Ababa, Ethiopia.

出版信息

Emerg Med Int. 2021 Mar 19;2021:9590859. doi: 10.1155/2021/9590859. eCollection 2021.

Abstract

BACKGROUND

Emergency medical care starts with airway assessment and intervention management. Endotracheal intubation is the definitive airway management in the emergency department (ED) for patients requiring a definitive airway. Successful first pass is recommended as the main objective of emergency intubation. There exists no published research regarding the success rates or complications that occur within Ethiopian hospitals emergency department intubation practice.

OBJECTIVE

This study aimed to assess the success rate of emergency intubations in a tertiary hospital, Addis Ababa, Ethiopia. . This was a single institute retrospective documentation review on intubated patients from November 2017 to November 2018 in the emergency department of Addis Ababa Burn Emergency and Trauma Hospital. All intubations during the study period were included. Data were collected by trained data collectors from an intubation documentation sheet.

RESULT

Of 15,933 patients seen in the department, 256 (1.6%) patients were intubated. Of these, 194 (74.9%) were male, 123 (47.5%) sustained trauma, 65 (25.1%) were medical cases, and 13(5%) had poisoning. The primary indications for intubation were for airway protection (160 (61.8%)), followed by respiratory failure (72(27.8%)). One hundred and twenty-nine (49.8%) had sedative-only intubation, 110 (42.5%) had rapid sequence intubation, and 16 (6.2%) had intubation without medication. The first-pass success rate in this sample was 70.3% (180/256), second-pass 21.4% (55/256), and third-pass 7.4% (19/256), while the overall success rate was 99.2% (254/256). Hypoxia was the most common complication.

CONCLUSION

The intubation first-pass success rate was lower than existing studies, but the overall intubation success rate was satisfactory.

摘要

背景

急诊医疗护理始于气道评估和干预管理。气管插管是急诊科对需要确定性气道的患者进行确定性气道管理的方法。推荐首次插管成功作为急诊插管的主要目标。目前尚无关于埃塞俄比亚医院急诊科插管操作成功率或并发症的已发表研究。

目的

本研究旨在评估埃塞俄比亚亚的斯亚贝巴一家三级医院的急诊插管成功率。这是一项单机构回顾性文献研究,研究对象为2017年11月至2018年11月在亚的斯亚贝巴烧伤急诊与创伤医院急诊科接受插管的患者。纳入研究期间的所有插管病例。数据由经过培训的数据收集人员从插管记录表中收集。

结果

在该科室就诊的15933例患者中,256例(1.6%)接受了插管。其中,194例(74.9%)为男性,123例(47.5%)为创伤患者,65例(25.1%)为内科病例,13例(5%)为中毒患者。插管的主要指征是气道保护(160例(61.8%)),其次是呼吸衰竭(72例(27.8%))。129例(49.8%)仅使用镇静剂插管,110例(42.5%)进行快速顺序插管,16例(6.2%)未使用药物插管。该样本的首次插管成功率为70.3%(180/256),第二次为21.4%(55/256),第三次为7.4%(19/256),而总体成功率为99.2%(254/256)。低氧是最常见的并发症。

结论

插管首次成功率低于现有研究,但总体插管成功率令人满意。

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