외상 환자에서 Glidescope 비디오후두경을 이용한 응급기도관리

Abstract

Purpose: To describe the current status of airway management for trauma patients in the emergency department (ED) and to evaluate the success rate and associated factors for selecting the Glidescope video laryngoscope. Methods: This was a retrospective observational study of prospectively collected data from the Koran Emergency Airway Management Registry in two university hospitals between April 2006 and March 2010. The study population included all trauma patients presenting at the ED who required emergency airway management. Demographic and airway related parameters were collected. The success rate was compared between the Glidescope and the direct laryngoscope. Factors associated with selecting the Glidescope were analyzed using multiple logistic regression. Results: Among the 1,974 patients who received airway management in the ED during the study period, 341 were identified as trauma patients. The Glidescope was used in 130 (38%) of the patients. Difficult airway was identified in 46.9% of the Glidescope group compared with 22.6% in the direct laryngoscope group (p<0.001). Success rate on the first attempt was not different between the direct laryngoscope and the Glidescope. The Glidescope was selected in favor of cervical immobilization, difficult airway, and senior grade resident. Conclusion: Among intubated patients in the ED, trauma patients accounted for 17.6%. The Glidescope video laryngoscope was selected in 38% of cases. It was usually used in cases of difficult airway such as cervical immobilization by senior grade residents