气管插管袖带压力 – 两种填充方法的比较 – 模拟测试,Prehospital and Disaster Medicine

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气管插管袖带压力 – 两种填充方法的比较 – 模拟测试
Prehospital and Disaster Medicine ( IF 2.1 ) Pub Date : 2021-04-30 , DOI: 10.1017/s1049023x21000406
Tomasz Ilczak ₁ , Michał Ćwiertnia ₁ , Piotr Białoń ₁ , Michał Szlagor ₁ , Beata Kudłacik ₁ , Małgorzata Rak _{1,

2} , Szymon Bialka ₃ , Adam Ubych ₃ , Arkadiusz Stasicki ₁ , Wioletta Waksmańska ₄ , Jan Bujok ₅ , Monika Mikulska ₁ , Rafał Bobiński ₅ , Marek Kawecki ₁

Affiliation

简介：气管插管是开放气道的最佳方法。如果执行得当，它可以防止胃内容物进入呼吸道，并允许在心脏骤停期间进行异步心肺复苏 (CPR)。正确插管的一个重要因素是气管插管袖带的正确充气。研究表明，当医务人员使用触诊技术时，袖带通常充气不正确。这可能导致患者出现许多健康并发症。方法：本研究于 2020 年对一组参加在别尔斯科-比亚拉（波兰）举行的第 15 届国际冬季医疗救援者锦标赛的医护人员进行。该研究的目的是评估两种充气气管插管袖带的方法。方法 A 涉及使用注射器给袖带充气，并使用触诊技术评估对照袖带中的压力。方法 B 涉及使用压力计给袖带充气。在充气过程中，记录袖带充气压力和完成程序所需的时间。还对完成认证的高级生命支持 (ALS) 和高级心血管生命支持 (ACLS) 培训是否对充气程序的有效性有任何影响进行了分析。结果：研究表明，使用方法 B 的医护人员比使用方法 A 的医护人员更频繁地将气管插管袖带充气至正确的压力。但是，使用方法 B 时，该过程需要更长的时间来进行。该研究还表明，完成经认证的 ALS 或 ACLS 培训对袖带的适当充气没有显着影响。那些完成了认证培训课程的人在使用方法 A 时为气管插管袖带充气需要更长的时间。结论：使用注射器给气管插管袖带充气，然后用触诊技术评估袖带气球的充气情况，是无效。医护人员应配备压力计，用于给气管插管袖带充气。其次是触诊技术来评估袖带球囊的膨胀情况，是无效的。医护人员应配备压力计，用于给气管插管袖带充气。其次是触诊技术来评估袖带球囊的膨胀情况，是无效的。医护人员应配备压力计，用于给气管插管袖带充气。

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Endotracheal Tube Cuff Pressure – Comparison of the Two Filling Methods – Simulated Test

Introduction: Tracheal intubation is the optimal method for opening up airways. Performed correctly, it prevents stomach contents from entering the respiratory tract and allows asynchronous cardiopulmonary resuscitation (CPR) to be conducted during sudden cardiac arrest. An important element of correct intubation is proper inflation of the endotracheal tube cuff. Research has shown that when medical personnel use the palpation technique, the cuff is usually inflated incorrectly. This can result in numerous health complications for the patient. Methods: This research was conducted in 2020 on a group of paramedics participating in the 15th International Winter Championship of Medical Rescuers in Bielsko-Biala (Poland). The aim of the research was to assess two methods of inflating the endotracheal tube cuff. Method A involved inflating the cuff using a syringe and assessing the pressure in the control cuff using the palpation technique. Method B involved inflating the cuff using a manometer. During the inflation, both the cuff inflation pressure and the time required to complete the procedure were recorded. Analysis was also conducted on whether completion of certified Advanced Life Support (ALS) and Advanced Cardiovascular Life Support (ACLS) training had any influence on the effectiveness of the inflation procedure. Results: The research showed that paramedics using Method B significantly more often inflated the endotracheal tube cuff to the correct pressure than those using Method A. However, when Method B was used, the procedure took longer to conduct. The study also showed that completion of certified ALS or ACLS training did not have a significant influence on proper inflation of the cuff. Those who had completed certified training courses took significantly longer to inflate the endotracheal tube cuff when using Method A. Conclusions: Inflation of the endotracheal tube cuff by use of a syringe, followed by the palpation technique for assessing the inflation of the cuff balloon, is ineffective. Paramedic teams should be equipped with manometers to be used for inflating the endotracheal tube cuff.

更新日期：2021-04-30

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