以成人为基础的社区医院系统插管儿童的结局和随访:回顾性图表回顾。

0 CRITICAL CARE MEDICINE
Canadian Journal of Respiratory Therapy Pub Date : 2022-06-10 eCollection Date: 2022-01-01 DOI:10.29390/cjrt-2022-015
Mika L Nonoyama, Vinay Kukreti, Efrosini Papaconstantinou, Natascha Kozlowski, Sarah Tsimelkas
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引用次数: 0

摘要

目的:儿童急诊插管是一项高风险手术。描述在儿科中心以外的地方插管实践的研究是稀缺和多样化的。本研究描述了以成人为基础的社区急诊科(ed)的儿科插管情况,确定了与插管相关不良事件(ae)相关的因素,并描述了转至四级护理儿科机构的儿童的结局。方法:回顾性分析2006年1月至2017年3月在Lakeridge健康与病童医院(SickKids)收集的数据。结果:分析患者(n = 121),中位年龄(四分位间距(IQR))为3.7(0.4-14.3)岁。有76例(62.8%)FPS,儿科医生(n = 25, 23%)或麻醉师(n = 12, 11%)与所有其他提供者(护理人员n = 13(12%),急诊科医生n = 37(34%),呼吸治疗师n = 20(18%),转院小组n = 2(2%))之间无差异。不良反应发生率为24例(19.8%,轻微不良反应21例,严重不良反应3例),儿科医生和麻醉师与其他所有提供者的不良反应发生率无显著差异。来自68名转至SickKids的患儿的数据可用,大多数患儿在入院的短中位(IQR)时间内拔管,1.2(0.29-3.8)天。结论:在加拿大以成人为基础的社区医院系统中,儿科插管是罕见的。大多数插管显示FPS与相对较少的ae,卫生提供者类型之间无显著差异。未来的调查应利用多中心数据,为组织独特的实践文化(包括培训计划)提供适合的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review.

Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review.

Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review.

Objectives: Emergency intubation is a high-risk procedure in children. Studies describing intubation practices in locations other than pediatric centres are scarce and varied. This study described pediatric intubations in adult-based community emergency departments (EDs) and determined what factors were associated with intubated-related adverse events (AEs) and described outcomes of children transferred to a quaternary care pediatric institution.

Methods: This is a retrospective review of data collected between January 2006 and March 2017 at Lakeridge Health and Hospital for Sick Children (SickKids). Patients were <18 years and intubated in Lakeridge Health EDs; those intubated prior to ED arrival were excluded. Primary outcomes were intubation first-pass success (FPS) and AEs secondary to intubation.

Results: Patients (n = 121) were analyzed, and median (interquartile range (IQR)) age was 3.7 (0.4-14.3) years. There were 76 (62.8%) FPS, with no difference between pediatricians (n = 25, 23%) or anaesthetists (n = 12, 11%), versus all other providers (paramedic n = 13 (12%), ED physician n = 37 (34%), respiratory therapist n = 20 (18%), transfer team n = 2 (2%)). The proportion of AEs was 24 (19.8%, n = 21 minor, n = 3 major), with no significant difference between pediatricians or anaesthetists versus all other providers. Data from 68 children transferred to SickKids were available, with the majority extubated within a short median (IQR) time of admission, 1.2 (0.29-3.8) days.

Conclusions: Pediatric intubations were rare in a Canadian adult-based community hospital system. Most intubations demonstrated FPS with relatively few AEs and no significant differences between health provider type. Future investigations should utilize multi-centred data to inform strategies suited for organizations' unique practice cultures, including training programs.

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来源期刊
Canadian Journal of Respiratory Therapy
Canadian Journal of Respiratory Therapy Health Professions-Health Professions (miscellaneous)
CiteScore
2.00
自引率
0.00%
发文量
34
期刊介绍: The CJRT is published four times a year and represents the interests of respiratory therapists nationally and internationally. The CJRT has been redesigned to act as an educational dissemination tool. The CJRT encourages submission of original articles, papers, commentaries, case studies, literature reviews and directed reading papers. Submissions can be sent to Rita Hansen.
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