The effect of early airway evaluation in rescue of critical patients in emergency room
10.3760/cma.j.issn.1673-4904.2014.01.009
- VernacularTitle:早期气道状况评估对急诊科危重症患者救治的影响
- Author:
Ying WU
- Publication Type:Journal Article
- Keywords:
Airway management;
Emergency service,hospital;
Endotracheal intubation
- From:
Chinese Journal of Postgraduates of Medicine
2014;37(1):27-29
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of early airway evaluation in critical patients in emergency room.Methods One hundred and sixty-six critically ill patients with routine intubation,according to the condition of early airway evaluation,were divided into early-estimate group (86 cases) and control group (80 cases).The patients in control group due to illness change needed to build artificial airway,tracheal intubation for the first time was done by the doctor on duty,and before intubation grading evaluation of airway was made.The patients in early-estimate group in emergency room had been early estimated using improved Mallampati classification and Thyromental distance by the doctor on duty.The number of cases with first successful endotracheal intubation,endotracheal intubation time,cases with forecast of difficult airway,the number of cases forecast of difficult airway intubation with first time successful endotracheal intubation,the number of cases failed in intubation and needed emergency tracheotomy,and the time of relatively stable vital signs,emergency department mortality were recorded in two groups.Results The endotracheal intubation time,forecast of difficult airway,rate of failing in intubation and needing emergency tracheostomy tube had no statistical significance (P ＞ 0.05).The first time success rate of tracheal intubation and forecast of difficult airway intubation in early-estimate group were higher than those in control group [69.4％ (59/85)vs.40.0％ (32/80),80.0％ (28/35) vs.32.3％ (10/31)],the time of rehtively stable vital signs was shorter than that in control group[(89.5 ± 23.2) min vs.(110.4 ± 48.2) min],emergency department mortality was lower than that in control group [8.2％(7/85) vs.18.8％(15/80)],and the difference was statistically significant (P ＜ 0.05).Conclusion Early-estimation in the emergency room for the critical patients and preparing for the corresponding work is helpful to improve the success rate of first intubation in the patients with difficult airway,and to restore stability to achieve the safe transfer standard as soon as possible.
