Airway aux urgences en Corée: Avec quoi ?

Assessment of Emergency Airway Management Techniques in Korea Using an Online Registration System: A Multicenter Study.

Press GM et AL. J Emerg Med. 2014 Dec;47(6):638-45

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L'essor de la vidéo-laryngoscopie est incontournable. Ceci  ne doit cependant pas faire oublier que cet outil ne remplace pas (encore) la pratique régulière de la laryngoscopie directe notamment dans le cadre de la prise en charge des traumatisés. C'est du moins ce que laisse entendre ce document coréen qui pointe  néanmoins l'apport de cette dernière dans les conditions d'intubation diffiicle.

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BACKGROUND:

 

The investigators developed a Web-based online registration system to identify the current status of trauma airway management.

OBJECTIVES:

The purpose of the study was to identify first-pass success (FPS) rate of the intubation methods and devices that are currently used, as well as the factors that affect FPS in trauma patients.

METHODS:

This study was designed as a prospective, observational multi-center study. We obtained clinical data of intubated trauma patients in 13 academic emergency departments in Korea. After performing an intubation, each patient's data were entered into a Web-based registry. Logistic regression analyses were conducted to identify the factors that affect FPS.

RESULTS:

The FPS rate was 80.6% in all trauma patients. The curved-blade laryngoscope was the most commonly used instrument, and was applied to 1395 patients (76.2%) during first attempt. Video laryngoscopy was applied to 341 patients (18.6%). In the multivariate logistic regression analysis, factors that affected FPS in difficult airway trauma patients were emergency physicians, senior physicians, and video laryngoscopy (odds ratio 2.42, 95% confidence interval 1.04-5.65; 1.80, 1.16-2.79; and 2.16, 1.39-3.33, respectively).

CONCLUSIONS:

Emergency physicians in Korea are prepared for trauma patient airway management. The backup by experienced senior physicians, and preparation and training for video laryngoscope could assist FPS for trauma patients.