Adult foreign body airway obstruction in the prehospital setting
Adult foreign body airway obstruction in the prehospital setting
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DOI：
10.1080/10903120601023263
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发表时间：
2007-01-01
影响因子：
2.4
通讯作者：
Vilke, Gary M.
中科院分区：
文献类型：
--
作者：
Soroudi, Arash;Shipp, Holly E.;Vilke, Gary M.
背景尽管成人异物气道阻塞的治疗已经得到了很好的研究，但关于院前经历特征的数据却很少。目标.描述院前环境中成人异物气道阻塞的频率、病因和治疗，并讨论治疗的相对有效性和预测患者总体结局的因素。方法.回顾性审查了圣地亚哥县院前数据库中17个月内所有成年患者的人口统计学特征、事件结局、患者处置、梗阻相关项目、发作位置、初始生命体征、初始意识水平、相关病史、旁观者和护理人员启动的治疗以及对这些治疗的反应。结果在研究期间，有513例成人异物气道阻塞。其中17例（3.3%）死亡。平均年龄为65.0岁，年龄增加与预后不良相关。引起梗阻的物品种类繁多，药物和肉类是最常见的物品。海姆利克氏操作法是最常用的干预措施，患者改善率为86.5%。马吉尔钳被证明是有用的3例难治性海姆利克氏手法。出现生命体征异常，特别是呼吸频率异常，与患者预后较差相关。结论.异物性气道阻塞在成人中是真正的急症，在目前的研究中死亡率为3.3%。海姆利克氏操作法被频繁使用，并取得了良好的成功。
Background. Although the treatment of foreign body airway obstruction in adults has been well studied, few data exist on the characterization of prehospital experiences. Objectives. To describe the frequency, etiologies, and treatments of foreign body airway obstruction in adults in the prehospital setting and to discuss the relative efficacies of treatments and presenting factors that predict overall patient outcome. Methods. A San Diego County prehospital database was retrospectively reviewed for all adult patients over a 17-month period with data extracted on demographic characteristics, incident outcome, patient disposition, item involved in obstruction, location of episode, initial vital signs, initial level of consciousness, pertinent medical history, treatments initiated by bystanders and paramedics, and response to those treatments. Results. During the study period, there were 513 cases of foreign body airway obstruction in adults. Of these, 17 (3.3%) died. The mean age was 65.0 years, with increasing age correlating with worse outcome. The item causing obstruction varied widely, with medications and meat being the most common items. The Heimlich maneuver was the most commonly used intervention, with an 86.5% rate of patient improvement. Magill forceps proved useful for three cases refractory to the Heimlich maneuver. Presenting vital sign aberrations, particularly with respiratory rate, correlated with poorer patient outcome. Conclusions. Foreign body airway obstruction represents a true emergency in adults, with a 3.3% mortality rate in the current study. The Heimlich maneuver was used frequently and with good success.