A Comparative Study of Airway Assurance for Patients Presented with Cardiopulmonary Arrest in the Prehospital Setting Between the Esophageal Obstructive Airway and Endotracheal Intubation
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概要
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Eleven years have passed since the Emergency Lifesaving Technician Law was enacted in Japan. Emergency lifesaving technicians are permitted to secure the airway by instrument insertion, secure intravenous access using Ringer's lactate, and conduct defibrillation in patients with out-of-hospital cardiac arrest, but the range of their authority has not been expanded during these 10 years. Debate has thus arisen on whether emergency lifesaving technicians should conduct tracheal intubation, but in Japan there has been very little comparison of tracheal intubation versus other methods to establish airways in patients with out-of-hospital cardiopulmonary arrest. From January 2001 to December 2001, we compared arterial blood gas analysis data and chest radiography at arrival at the Department of Emergency and Critical Care Medicine, Sapporo General Hospital, of patients with nontraumatic out-of-hospital cardiopulmonary arrest who received esophageal obturator airway (EOA) insertion by an emergency lifesaving technician versus those who received tracheal intubation (TI) by a physician in the ambulance. Mean arterial partial oxygen pressure was 150.0±120.9mmHg in 55 patients in the EOA group and 260.6±173.7mmHg in 71 patients in the TI group, ---- was significantly higher in the TI group (p<0.001). Although the mean arterial oxygen partial pressure of 150mmHg in the EOA group may be considered acceptable, partial pressure was less than 80mmHg in 21 patients (38%). Pulmonary congestion and pulmonary edema were frequently seen in the chest radiography on admission, and conversion to tracheal intubation improved oxygenation in two-thirds of these patients. These results suggest that tracheal intubation is better than EOA in establishing an airway in patients with out-of-hospital cardiopulmonary arrest, and may also serve as useful information in determining whether emergency lifesaving technicians should be permitted to conduct tracheal intubation.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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