Hackeling T, Triana R, Ma O J, Shockley W
Department of Emergency Medicine, University of North Carolina, Chapel Hill 27599-7594, USA.
Am J Emerg Med. 1998 Nov;16(7):681-5. doi: 10.1016/s0735-6757(98)90176-0.
The emergency department (ED) care of a patient with a tracheostomy tube can be problematic because of difficulty with patient communication, urgency of airway control, and unfamiliarity with tracheal equipment. The objective of this study was to characterize complications of tracheostomy patients seen in the ED and provide management techniques. A retrospective study was conducted on all patients with tracheostomy complications who presented to a university, tertiary-care ED over a 7-year period. Data obtained included age, gender, operative indication, complication, time of complication, vital signs, and ED management. Descriptive statistics were used to analyze the data. During the study period, 35 patients were evaluated in the ED for 60 complications. The 60 complications were categorized into six groups: 20 (33%) patients presented with dislodged tracheal tubes, 11 (18%) presented with plugged tracheal tubes, 18 (30%) had infection, 7 (11%) had bleeding, 1 (3%) had a pnuemothorax, and 3 (5%) had tracheal/stomal stenosis. Review of the complications that place tracheostomy patients at high risk in conjunction with a review of the literature enabled the development of a standard approach to dealing with patients with tracheostomies that can facilitate proper care of the patients in the ED.
由于患者沟通困难、气道控制紧急以及对气管设备不熟悉，急诊科（ED）对气管造口术患者的护理可能存在问题。本研究的目的是描述在急诊科就诊的气管造口术患者的并发症，并提供处理技术。对一所大学三级护理急诊科7年内所有出现气管造口术并发症的患者进行了回顾性研究。获得的数据包括年龄、性别、手术指征、并发症、并发症发生时间、生命体征和急诊科处理情况。使用描述性统计分析数据。在研究期间，35例患者因60种并发症在急诊科接受评估。这60种并发症分为六组：20例（33%）患者出现气管导管移位，11例（18%）出现气管导管堵塞，18例（30%）发生感染，7例（11%）出血，1例（3%）气胸，3例（5%）气管/造口狭窄。回顾使气管造口术患者处于高风险的并发症，并结合文献回顾，形成了一种处理气管造口术患者的标准方法，有助于在急诊科对患者进行妥善护理。
