Critical Care Operating Unit, South East Coast Ambulance Service NHS Foundation Trust, Nexus House, 4 Gatwick Road, Crawley, RH10 9BG, UK.
BMC Emerg Med. 2021 Nov 20;21(1):144. doi: 10.1186/s12873-021-00533-0.
Drug-free tracheal intubation has been a common intervention in the context of out-of-hospital cardiac arrest for many years, however its use by paramedics has recently been the subject of much debate. Recent international guidance has recommended that only those achieving high tracheal intubation success should continue to use it.
We conducted a retrospective service evaluation of all drug-free tracheal intubation attempts by specialist paramedics (critical care) from South East Coast Ambulance Service NHS Foundation Trust between 1st January and 31st December 2019. Our primary outcome was first-pass success rate, and secondary outcomes were success within two attempts, overall success, Cormack-Lehane grade of view, and use of bougie.
There were 663 drug-free tracheal intubations and following screening, 605 were reviewed. There was a first-pass success rate of 81.5%, success within two attempts of 96.7%, and an overall success rate of 98.35%. There were ten unsuccessful attempts (1.65%). Bougie use was documented in 83.4% on the first attempt, 93.5% on the second attempt and 100% on the third attempt, CONCLUSION: Specialist paramedics (critical care) are able to deliver drug-free tracheal intubation with good first-pass success and high overall success and are therefore both safe and competent at this intervention.
多年来，无药物气管插管一直是院外心脏骤停情况下的常见干预措施，但最近急救人员对此的使用引起了广泛争议。最近的国际指南建议，只有那些能够实现高气管插管成功率的人才能继续使用它。
我们对 2019 年 1 月 1 日至 12 月 31 日期间东南海岸救护车服务 NHS 基金会信托的专科护理人员（重症护理）进行了所有无药物气管插管尝试的回顾性服务评估。我们的主要结果是首次通过成功率，次要结果是两次尝试内的成功率、总体成功率、Cormack-Lehane 分级视图和使用支气管镜。
有 663 例无药物气管插管，经过筛选后，有 605 例进行了回顾。首次通过成功率为 81.5%，两次尝试内成功率为 96.7%，总体成功率为 98.35%。有 10 次尝试失败（1.65%）。首次尝试时有 83.4%记录了支气管镜使用，第二次尝试时有 93.5%，第三次尝试时有 100%。
专科护理人员（重症护理）能够进行无药物气管插管，首次通过成功率高，总体成功率高，因此在这种干预措施中既安全又有能力。
