Aeromedical Operations, NSW Ambulance Service, New South Wales, Australia; Department of Paramedicine, Monash University, Melbourne, Victoria, Australia.
Aeromedical Operations, NSW Ambulance Service, New South Wales, Australia.
Air Med J. 2024 Mar-Apr;43(2):157-162. doi: 10.1016/j.amj.2023.11.013. Epub 2023 Dec 24.
Desaturation during prehospital rapid sequence intubation (RSI) is common and is associated with patient morbidity. Past studies have identified oxygen saturations at induction, the grade of laryngoscopy, and multiple attempts to intubate as being associated with desaturation. This study aimed to investigate whether there are other factors, identifiable before RSI, associated with desaturation.
This was a study of a physician-paramedic critical care team operating as Aeromedical Operations, NSW Ambulance. Prehospital RSIs (using paralysis) were studied retrospectively via patient case notes, monitor data, and an airway database. The review occurred between April 1, 2016, and December 31, 2018. Desaturation was defined as monitor recordings of saturations ≤ 92%. Logistic regression was performed for factors likely to be associated with desaturation.
Desaturation occurred in 67 of 350 (19.1%) RSIs. Factors significantly associated with desaturation included male sex, a chest injury, increased weight, and lower saturations pre-RSI.
Increased weight, chest injuries, and lower oxygen saturations are associated with desaturation at RSI. The variable male sex may be a surrogate for other as-yet unidentified factors.
院前快速序贯插管（RSI）过程中的脱氧是很常见的，并且与患者的发病率有关。过去的研究已经确定了诱导时的氧饱和度、喉镜检查的等级以及多次插管尝试与脱氧有关。本研究旨在调查在 RSI 之前是否存在其他与脱氧相关的可识别因素。
这是一项针对作为航空医疗运营机构的新南威尔士州救护车的医生-护理人员重症监护团队的研究。通过患者病历、监测数据和气道数据库对院前 RSI（使用麻痹）进行回顾性研究。审查发生在 2016 年 4 月 1 日至 2018 年 12 月 31 日之间。脱氧被定义为监测记录的饱和度≤92%。对可能与脱氧相关的因素进行逻辑回归分析。
在 350 次 RSI 中，有 67 次出现脱氧。与脱氧显著相关的因素包括男性、胸部损伤、体重增加和 RSI 前的低饱和度。
体重增加、胸部损伤和低氧饱和度与 RSI 时的脱氧有关。性别这一可变因素可能是其他尚未确定的因素的替代指标。
