A prospective observational study of tracheal intubation in an emergency department in a 2300-bed hospital of a developing country in a one-year period

被引:19
作者
Wongyingsinn, M. [1 ]
Songarj, P. [1 ]
Assawinvinijkul, T. [2 ]
机构
[1] Mahidol Univ, Siriraj Hosp, Fac Med, Dept Anesthesiol, Bangkok 10700, Thailand
[2] Mahidol Univ, Siriraj Hosp, Fac Med, Dept Internal Med, Bangkok 10700, Thailand
关键词
RAPID-SEQUENCE INTUBATION; AIRWAY MANAGEMENT; MEDICINE; PHYSICIANS; INDUCTION;
D O I
10.1136/emj.2008.061192
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To assess the competency of physicians in the non-traumatic emergency department (ED) in intubating critically ill patients, to describe the methods, success rates and immediate complications after intubation in Siriraj Hospital. Method: A one-year prospective observational study of endotracheal intubation in the ED of Siriraj Hospital, which has an annual census of 150 518 patients. Data were collected by each intubator at the time of each intubation for indications, success rates, use of drugs to facilitate intubation and immediate complications of tracheal intubation and the outcomes of patients. Result: A total of 757 patients underwent endotracheal attempts in the ED, including 176 (23.2%) patients in cardiopulmonary arrest; 754 (99.6%) of these were successfully intubated and 602 (79.5%) patients were successfully intubated at the first attempt. Three patients could not be intubated and underwent surgical airway management. In non-cardiac arrest patients, intubation by neuromuscular blocking agent was performed in 16 (2.75%) patients only, and all the intubators were anaesthesiologists. 396 (68.1%) patients were successfully intubated without using any drug. 285 (37.6%) patients were found to have a total of 341 complications. Conclusion: At this institution, the majority of ED intubations were performed by residents and no drug was used. In this ED patients were intubated with a high success rate and a low rate of serious complications.
引用
收藏
页码:604 / 608
页数:5
相关论文
共 19 条
[1]  
*AM HEART ASS, 2005, CIRCULATION, P112
[2]  
CHARULUXANANAN S, 2001, J MED ASS THAI S1, V84, P251
[3]  
Dufour Daniel G., 1995, Journal of Emergency Medicine, V13, P705, DOI 10.1016/0736-4679(95)00089-S
[4]   EMERGENCY PROCEDURES IMPORTANT TO THE TRAINING OF EMERGENCY-MEDICINE RESIDENTS - WHO PERFORMS THEM IN THE EMERGENCY DEPARTMENT [J].
GALLAGHER, EJ ;
COFFEY, J ;
LOMBARDI, G ;
SAEF, S .
ACADEMIC EMERGENCY MEDICINE, 1995, 2 (07) :630-633
[5]   Rapid sequence intubation in Scottish urban emergency departments [J].
Graham, CA ;
Beard, D ;
Oglesby, AJ ;
Thakore, SB ;
Beale, JP ;
Brittliff, J ;
Johnston, MA ;
McKeown, DW ;
Parke, TRJ .
EMERGENCY MEDICINE JOURNAL, 2003, 20 (01) :3-5
[6]   Advanced airway management in the emergency department: What are the training and skills maintenance needs for UK emergency physicians? [J].
Graham, CA .
EMERGENCY MEDICINE JOURNAL, 2004, 21 (01) :14-19
[7]   Procedural competency in emergency medicine: The current range of resident experience [J].
Hayden, SR ;
Panacek, EA .
ACADEMIC EMERGENCY MEDICINE, 1999, 6 (07) :728-735
[8]   AIRWAY MANAGEMENT-PRACTICES IN EMERGENCY-MEDICINE RESIDENCIES [J].
MA, OJ ;
BENTLEY, B ;
DEBEHNKE, DJ .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 1995, 13 (05) :501-504
[9]   Prehospital rapid sequence induction by emergency physicians: Is it safe? [J].
Mackay, CA ;
Terris, J ;
Coats, TJ .
EMERGENCY MEDICINE JOURNAL, 2001, 18 (01) :20-24
[10]  
MCBRIEN ME, 1992, ARCH EMERG MED, V9, P177