院前急救快速顺序诱导麻醉
Prehospital emergency rapid sequence induction of anaesthesia.
作者信息
Graham C A, Meyer A D
机构信息
Department of Accident and Emergency Medicine, Royal Infirmary of Edinburgh.
出版信息
J Accid Emerg Med. 1997 Jul;14(4):219-21. doi: 10.1136/emj.14.4.219.
OBJECTIVE
To determine the number of and reasons for rapid sequence inductions done by accident and emergency (A&E) doctors out of hospital as part of the activities of the MEDIC 1 Flying Squad. "Rapid sequence induction" was defined as any attempted endotracheal intubation accompanied by use of drugs to assist intubation and ventilation, including opiates, benzodiazepines, intravenous and topical anaesthetics, and neuromuscular blocking drugs.
METHODS
Retrospective study of all MEDIC 1 and A&E records over the period 1 February 1993 to 28 February 1996 (37 months). The anaesthetic technique used, drugs used, complications, difficulties, reasons for induction out of hospital, and grade of doctor performing the technique were determined.
RESULTS
Various anaesthetic techniques were used to secure the airway definitively by endotracheal intubation. Several difficulties were encountered in the prehospital setting, all of which were dealt with successfully.
CONCLUSIONS
The lack of complications related to rapid sequence induction in prehospital care suggests that this technique is safe when done by A&E doctors on appropriate patients.
目的
确定作为MEDIC 1飞行小队活动一部分，急诊（A&E）医生在院外进行快速顺序诱导的次数及原因。“快速顺序诱导”定义为任何伴有使用药物辅助插管和通气的气管内插管尝试，这些药物包括阿片类药物、苯二氮䓬类药物、静脉和局部麻醉剂以及神经肌肉阻滞剂。
方法
对1993年2月1日至1996年2月28日（37个月）期间所有MEDIC 1和急诊记录进行回顾性研究。确定所使用的麻醉技术、药物、并发症、困难、院外诱导的原因以及实施该技术的医生级别。
结果
采用了各种麻醉技术通过气管内插管来确切确保气道安全。在院前环境中遇到了一些困难，但均成功解决。
结论
院前护理中与快速顺序诱导相关的并发症缺失表明，急诊医生在合适患者身上进行该技术时是安全的。
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