patient safety in pre-hospital emergency tracheal intubation a comprehensive meta-analysis of the intubation success rates of ems providers在院前紧急气管插管患者安全的全面分析ems提供商的插管成功率.pdfVIP

Lossius et al. Critical Care 2012, 16:R24 /content/16/1/R24 RESEARCH Open Access Patient safety in pre-hospital emergency tracheal intubation: a comprehensive meta-analysis of the intubation success rates of EMS providers Hans Morten Lossius1,2*, Jo Røislien1,3 and David J Lockey4,5 Abstract Introduction: Pre-hospital airway management is a controversial subject, but there is general agreement that a small number of seriously ill or injured patients require urgent emergency tracheal intubation (ETI) and ventilation. Many European emergency medical services (EMS) systems provide physicians to care for these patients while other systems rely on paramedics (or, rarely, nurses). The ETI success rate is an important measure of provider and EMS system success and a marker of patient safety. Methods: We conducted a systematic search of Medline and EMBASE to identify all of the published original English-language articles reporting pre-hospital ETI in adult patients. We selected all of the studies that reported ETI success rates and extracted information on the number of attempted and successful ETIs, type of provider, level of ETI training and the availability of drugs on scene. We calculated the overall success rate using meta-analysis and assessed the relationships between the ETI success rate and type of provider and between the ETI success rate and the types of drugs available on the scene. Results: From 1,070 studies initially retrieved, we identified 58 original studies meeting the selection criteria. Sixty- four per cent of the non-physician-manned services and 54% of the physician-manned services reported ETI success rates but the success rate reporting was incomplete in three studies from non-physician-manned services. Median success rate was 0.905 (0.491, 1.000). In a weighted linear regression analy