Thibodeau L G, Verdile V P, Bartfield J M
Department of Emergency Medicine, Albany Medical Center, NY 12208, USA.
Am J Emerg Med. 1997 Oct;15(6):562-5. doi: 10.1016/s0735-6757(97)90157-1.
This study sought to determine the incidence of aspiration after urgent endotracheal intubation (ET) performed in the emergency department (ED), and to offer a descriptive evaluation of these intubations. In a retrospective review of 133 charts, 87 patients met inclusion criteria. Aspiration occurred in 3 (3.5%) patients (95% confidence interval, 0%, 7.4%). One had witnessed aspiration, and 2 had positive sputum cultures. None of the 87 patients had a positive chest radiograph or unexplained hypoxemia up to 48 hours after ET. Rapid-sequence induction and oral ET was performed in 79 (91%) patients, whereas 4 spontaneously breathing patients were nasally intubated. Seventy percent of patients underwent ET by PGY I or II residents, 29% by PGY III or IV residents, and 1% by ED attending physicians. Seventy-seven patients were intubated on the first attempt, and airway blood or vomitus during ET was noted in 11 patients. This study offers significant descriptive information regarding urgent ET performed in the ED, and shows that aspiration after urgent ET occurs infrequently in ED patients.
本研究旨在确定在急诊科（ED）进行紧急气管插管（ET）后误吸的发生率，并对这些插管操作进行描述性评估。在对133份病历的回顾性研究中，87例患者符合纳入标准。3例（3.5%）患者发生误吸（95%置信区间，0%，7.4%）。1例为目击误吸，2例痰培养阳性。87例患者在ET后48小时内胸部X线片均为阴性，也无不明原因的低氧血症。79例（91%）患者采用快速顺序诱导和经口ET，4例自主呼吸患者采用鼻插管。70%的患者由住院医师第一年或第二年进行ET，29%由住院医师第三年或第四年进行，1%由急诊科主治医师进行。77例患者一次插管成功，11例患者在ET期间气道有血液或呕吐物。本研究提供了有关在ED进行紧急ET的重要描述性信息，并表明ED患者紧急ET后误吸很少发生。
