Emergency Department, Hôpitaux Universitaires de Strasbourg.
INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS), University of Strasbourg, Strasbourg.
Eur J Emerg Med. 2024 Feb 1;31(1):46-52. doi: 10.1097/MEJ.0000000000001091. Epub 2023 Oct 9.
Endotracheal intubation is a lifesaving procedure that is reportedly associated to a significant risk of adverse events. Recent trials have reported that the use of videolaryngoscope and of a stylet might limit this risk during emergency intubation.
The objective of this study was to provide a national description of intubation practices in French Emergency Departments (EDs).
We conducted an online nationwide survey by sending an anonymous 37-item questionnaire via e-mail to 629 physicians in French EDs between 2020 and 2022.
A single questionnaire was sent to a sole referent physician in each ED.
The primary endpoint was to assess the proportion of French EDs in which videolaryngoscopy was available for emergency intubation and its use in routine practice. Secondary endpoints included the presence of local protocol or standard of procedure for intubation, availability of capnography, and routine use of a stylet.
Of the surveyed EDs, 342 (54.4%) returned the completed questionnaire. A videolaryngoscope was available in 193 (56%) EDs, and direct laryngoscopy without a stylet was majorly used as the primary approach in 280 (82%) EDs. Among the participating EDs, 74% had an established protocol for intubation and 92% provided a capnography device for routine verification of tube position. In cases of difficult intubation, the use of a bougie was recommended in 227 (81%) EDs, and a switch to a videolaryngoscope in 16 (6%) EDs. The most frequently used videolaryngoscope models were McGrath Mac Airtraq (51%), followed by Airtraq (41%), and Glidescope (14%).
In this large French survey, the majority of EDs recommended direct laryngoscopy without stylet, with seldom use of videolaryngoscopy.
气管插管是一种有生命危险的程序，据报道与不良事件的发生有很大的关系。最近的试验报告称，使用视频喉镜和管芯可能会限制紧急插管过程中的这种风险。
本研究的目的是提供法国急诊室（ED）插管实践的全国性描述。
我们在 2020 年至 2022 年间，通过电子邮件向法国 ED 的 629 名医生发送了一份匿名的 37 项问卷调查，进行了一项在线全国性调查。
向每个 ED 的唯一指定医生发送一份问卷。
在接受调查的 ED 中，有 342 个（54.4%）返回了完整的问卷。193 个（56%）ED 配备了视频喉镜，280 个（82%）ED 主要使用直接喉镜且不使用管芯作为主要方法。在参与的 ED 中，74%有插管的既定方案，92%为常规验证管位置提供二氧化碳描记器设备。在困难插管的情况下，227 个（81%）ED 推荐使用管芯，16 个（6%）ED 建议切换到视频喉镜。最常使用的视频喉镜型号是 McGrath Mac Airtraq（51%），其次是 Airtraq（41%）和 Glidescope（14%）。
在这项大型法国调查中，大多数 ED 推荐使用不带管芯的直接喉镜，很少使用视频喉镜。
