Learning Curve of Upper Aerodigestive Tract Foreign Body Management for Otorhinolaryngology Residents.

Ching-Ching Chiu, Chien-Yu Huang, Keng-Ming Chang, Sheng-Chiao Lin, Yu-Hsi Liu, Pei-Hsun Liao, Chuan-Jen Hung, Chin-Fang Cho, Jyun-Yi Liao, Yun-Ying She, Bor-Hwang Kang
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引用次数: 4

Abstract

Introduction: Foreign body ingestion is the most common reason for otolaryngology specialist consultations in emergency departments. Among the different types of foreign bodies, fish bones are the most common, particularly in Asian populations. In Taiwan, upper aerodigestive tract foreign bodies (UADT-FBs) are mostly managed by residents in the otorhinolaryngology (ORL) department. Considering the learning curve required for all procedures, different management types between residents, and possible resulting safety issues, this study explored the outcomes of UADT-FB management by residents in different years of ORL training.

Materials and methods: The medical records of 2,283 patients who visited Kaohsiung Veterans General Hospital's Emergency Department for UADT-FB during June 2013-August 2019 were retrospectively reviewed. The reviewed data included the demographic data of enrolled patients, outcomes of foreign body management, and follow-up chart records of the patients.

Results: Among the 2,283 patients, 1,324 (58%) were found to be negative for foreign bodies, and foreign bodies in 951 (41.7%) were removed immediately. In the negative finding (NF) group, 2 (4.9%) patients were later found to be positive for foreign bodies during follow-up in the outpatient department. One (2.4%) patient developed a deep neck infection and esophageal perforation. The percentage of NFs decreased from 62.58% in residents in the first half of their first year (R1a) to 54% for third-year residents (R3). Comparing R1a with R3, the number needed to harm for retained UADT-FBs after patients visited the emergency department was 12.2.

Discussion/conclusion: This study provides data from 1 referral center regarding the management of UADT-FBs. With increasing resident training, the percentage of NFs declined from 62.58 to 54%. Young residents, especially those in the first 6 months of their training, should have senior residents perform a second examination if UADT-FBs are not found in suspected cases.

耳鼻咽喉科住院医师上呼吸道异物管理学习曲线。
简介:异物误食是耳鼻喉科专家在急诊科会诊的最常见原因。在不同类型的异物中,鱼骨是最常见的,尤其是在亚洲人群中。在台湾,上呼吸道异物(UADT-FBs)大多由耳鼻咽喉科(ORL)住院医师处理。考虑到所有程序所需的学习曲线、住院医师之间不同的管理类型以及可能产生的安全问题,本研究探讨了住院医师在不同ORL培训年限下的UADT-FB管理结果。材料与方法:回顾性分析2013年6月至2019年8月在高雄市荣民总医院急诊科就诊的2,283例UADT-FB患者的病历。回顾的资料包括入组患者的人口统计资料、异物处理的结果和患者的随访图表记录。结果:2283例患者中,1324例(58%)发现异物阴性,951例(41.7%)立即取出异物。阴性发现(NF)组2例(4.9%)患者在门诊随访时发现异物阳性。1例(2.4%)患者出现深颈部感染和食管穿孔。患NFs的比例从第一年上半年的62.58% (R1a)下降到第三年的54% (R3)。将R1a与R3进行比较,患者就诊急诊科后保留的uadt - fb需要损伤的数量为12.2。讨论/结论:本研究提供了来自1个转诊中心关于uadt - fb管理的数据。随着住院医师培训的增加,NFs的比例从62.58%下降到54%。如果在疑似病例中未发现UADT-FBs,年轻住院医师,特别是刚接受培训6个月的住院医师应让老年住院医师进行第二次检查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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