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福島県立医科大学学術成果リポジトリ = Fukushima Medical University Repository >
A 医学部 = School of Medicine >
a10 学術雑誌論文等 = Journal Article >
このアイテムの引用には次の識別子を使用してください:
http://ir.fmu.ac.jp/dspace/handle/123456789/653
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| タイトル: | Human and equipment resources for difficult airway management, airway education programs, and capnometry use in Japanese emergency departments: a nationwide cross-sectional study |
| 著者: | Ono, Yuko
Tanigawa, Koichi
Shinohara, Kazuaki
Yano, Tetsuhiro
Sorimachi, Kotaro
Inokuchi, Ryota
Shimada, Jiro |
| 学内所属: | 救急医療学講座
ふくしま国際医療科学センター |
| 誌名/書名: | International Journal of Emergency Medicine |
| 巻: | 10 |
| 開始ページ: | 28 |
| 発行日: | 2017年9月13日 |
| 抄録: | Background: Although human and equipment resources, proper training, and the verification of endotracheal intubation are vital elements of difficult airway management (DAM), their availability in Japanese emergency departments (EDs) has not been determined. How ED type and patient volume affect DAM preparation is also unclear. We conducted the present survey to address this knowledge gaps. Methods: This nationwide cross-sectional study was conducted from April to September 2016. All EDs received a mailed questionnaire regarding their DAM resources, airway training methods, and capnometry use for tube placement. Outcome measures were the availability of: (1) 24-h in-house back-up; (2) key DAM resources, including a supraglottic airway device (SGA), a dedicated DAM cart, surgical airway devices, and neuromuscular blocking agents; (3) anesthesiology rotation as part of an airway training program; and (4) the routine use of capnometry to verify tube placement. EDs were classified as academic, tertiary, high-volume (upper quartile of annual ambulance visits), and urban. Results: Of the 530 EDs, 324 (61.1%) returned completed questionnaires. The availability of in-house back-up coverage, surgical airway devices, and neuromuscular blocking agents was 69.4, 95.7, and 68.5%, respectively. SGAs and dedicated DAM carts were present in 51.5 and 49.7% of the EDs. The rates of routine capnometry use (47.8%) and the availability of an anesthesiology rotation (38.6%) were low. The availability of 24-h back-up coverage was significantly higher in academic EDs and tertiary EDs in both the crude and adjusted analysis. Similarly, neuromuscular blocking agents were more likely to be present in academic EDs, high-volume EDs, and tertiary EDs; and the rate of routine use of capnometry was significantly higher in tertiary EDs in both the crude and adjusted analysis. Conclusions: In Japanese EDs, the rates of both the availability of SGAs and DAM carts and the use of routine capnometry to confirm tube placement were approximately 50%. These data demonstrate the lack of standard operating procedures for rescue ventilation and post-intubation care. Academic, tertiary, and high-volume EDs were likely to be well prepared for DAM. |
| 出版者: | Springer |
| 本文の言語: | eng |
| このページのURI: | http://ir.fmu.ac.jp/dspace/handle/123456789/653 |
| 本文URL: | http://ir.fmu.ac.jp/dspace/bitstream/123456789/653/1/IntJEmergMed_10_28.pdf |
| ISSN: | 1865-1372
1865-1380 |
| DOI: | 10.1186/s12245-017-0155-6 |
| PubMed番号: | 28905252 |
| 関連ページ: | http://doi.org/10.1186/s12245-017-0155-6 |
| 権利情報: | © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. |
| 権利情報: | http://creativecommons.org/licenses/by/4.0/ |
| 出現コレクション: | a10 学術雑誌論文等 = Journal Article
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