Out-of-hospital airway management in the United States.
作者： Henry E. Wang , N. Clay Mann , Gregory Mears , Karen Jacobson , Donald M. Yealy
DOI: 10.1016/J.RESUSCITATION.2010.12.014
关键词:
摘要: Objective: Prior studies describe airway management by single EMS agencies, regions or states. We sought to characterize out-of-hospital interventions, outcomes and complications across the United States. Methods: Using 2008 National Emergency Medical Services Information System (NEMSIS) PublicRelease Data Set containing data from 16 states, we identified patients receiving advanced management, including endotracheal intubation (ETI), alternate airways (Combitube, Laryngeal Mask Airway (LMA), King LT, Esophageal-Obturator (EOA)), cricothyroidotomy (needle open). examined success in full cohort key subsets (cardiac arrest, non-arrest medical, injury, children <10 10–19 years, rapid-sequence (RSI), population setting US census region). analyzed using descriptive statistics. Results: Among 4,383,768 activations, there were 10,356 ETI, 2246 airways, 88 cricothyroidotomies. ETI rates were: overall 6482/8418 (77.0%; 95% CI: 76.1–77.9%), cardiac arrest 3494/4482 (78.0%), medical 616/846 (72.8%), injury 417/505 (82.6%), years 295/397 (74.3%), 228/289 (78.9%), adult 5829/7552 (77.2%), rapidsequence 289/355 (81.4%). was lowest South region. Alternate 1564/1794 (87.2%). Major included: bleeding 84 (7.0 per 1000 interventions), vomiting 80 (6.7 1000) esophageal 12 (1.0 1000). Conclusions: In this study characterizing States, observed low rates. These may guide national efforts improve quality of management.
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