院间转诊患者人工气道气囊压力管理现状调查

Investigation on management of artificial airway cuff pressure in referral patients

目的检测院间转运患者人工气道的气囊压力,并调查转诊护士对人工气道气囊压力管理现状,为规范院间转诊人工气道气囊压力管理提供依据。方法采用气囊压力表对153例经院间转诊,且带人工气道的患者测量气囊内压力,并对142名转诊护士进行气囊管理相关知识问卷调查。结果153例患者中,气囊压力控制在20~30cmH_2O占55.56%,压力小于20cmH_2O占30.07%,压力高于30cmH2O占14.38%。不同医院级别及是否接受过相关培训的转诊护士气囊管理相关知识得分比较,差异有统计学意义(均P<0.05)。94.37%医院未在救护车上配备气囊测压表进行气囊压力监测。结论院间转诊患者人工气道气囊压力管理现状不容乐观。为减少因气囊压力改变而导致的危害,应将院间转诊患者气囊压力保持在一个合理的范围内。应加强转诊护士关于院间转诊过程中人工气道气囊压力管理相关知识的培训。

Objective To test the pressure of artificial airway cuff in patient who were transported to a tertiary hospital, to investigate escort nurses＇ management of artificial airway cuff pressure, and to provide evidence for standardized artificial airway cuff pressure management of hospital referral. Methods Researchers used a cuff pressure gauge to measure the artificial airway cuff pressure of 153 patients who were transported to the emergency department of a tertiary hospital from other hospitals carrying an artificial air way. Meanwhile, a questionnaire survey was carried out to assess 142 escort nurses＇ knowledge of cuff management. Results The artificial airway cuff pressure was measured within 20-30 cmH20 for 55.6% of the patients, less than 20 cmH20, for 30.1%, and higher than 30 cmH20 for 14.3%. Escort nurses who were from tertiary hospital, and who had receive related trainings had higher knowledge scores of cuff management （P〈0.05 for both）. As high as 94. 37% of the hospitals didn＇t provide pressure gauge for escort nurses to monitor the cuff pressure. Conclusion Management of artificial airway cuff pressure by escort nurses is less satisfactory. In order to minimize the harm induced by cuff pressure changes, cuff pressure should be maintained at a reasona hie range during transport. Artificial airway cuff pressure management training programs should be provided to escort nurses.