Abstract:
Objective To analyze the adverse events related to endotracheal intubation in the emergency department of critical medicine, and to improve the ability to prevent and handle the emergency.
Methods Using retrospective research methods, the adverse events and post emergency treatment of endotracheal intubation patients from January 2015 to December 2018, in three departments (emergency ICU, emergency medical monitoring unit and comprehensive ICU) in an emergency intensive care unit of Nantong First People’s Hospital were surveyed. A total of 392 patients were enrolled, including 204 males and 188 females, aged from 16 to 93 years, with an average of (54.62±6.28) years. The changes of vital signs before and after the adverse events were compared by adjusting the position of the catheter, thoroughly clearing the airway secretions, adding oxygen to the mask simple respirator, re-intubation or percutaneous dilation tracheotomy. Non punitive reporting of adverse events were encouraged, and the type, time distribution, annual distribution, department distribution and cause distribution of adverse events were analyzed.
Results There were 53 adverse events in 392 patients with tracheal intubation, and the incidence rate was 13.5%. One patient with comprehensive ICU experienced difficulty in intubation during tracheal tube replacement. Considering laryngeal edema, family members gave up tracheotomy and further treatment. Another patient with severe obesity had difficulty with airways, and the anesthesiologist was requested to assist with balloon leakage after intubation. The family refused to intubate or tracheostomy again, and gave up treatment. The remaining 51 cases were quickly processed on the spot, and the vital signs indicators returned to the state before the adverse event, without serious consequences.
Conclusion The incidence of adverse events related to oral tracheal intubation in the emergency and critical medicine department is relatively high. Active prevention and rapid on-site judgment and correct treatment can reduce patient suffering and prevent serious adverse consequences.
Key words:
tracheal intubation,
adverse events,
emergency treatment
Haiyan Wu, Chaoli Gu, Liyuan Zhang. Emergency management of tracheal intubation-related adverse events in Emergency Critical Care Department[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2020, 06(02): 88-91.