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What happens to SpO2 during air medical crew intubations?

机译：空中医疗人员插管过程中SpO2会发生什么变化？

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OBJECTIVES: Studies finding adverse outcomes associated with emergency medical services intubation (ETI) have prompted recommendations for prehospital services to improve tracking of oxygenation during airway management. Our goals were to 1) implement a documentation requirement for helicopter EMS (HEMS) crews, entailing tracking and notation of the lowest SpO2 value (peri-ETI SpO2 nadir) occurring during HEMS crew ETI, and 2) assess the findings associated with the peri-ETI SpO2 documentation parameter. METHODS: This was a prospective study conducted at an urban HEMS program with flight nurse/flight paramedic staffing and protocol-driven care. There were 200 consecutive cases undergoing HEMS ETI between April 2004 and July 2005. Univariate logistic regression with odds ratio (OR) was used to assess for association between ETI-related hypoxemia (decrease in SpO2 value to < 90% during ETI) and patient/intubator characteristics. RESULTS: HEMS crew ETI was successful in 189 (95.4%) of the 200 patients. The lowest peri-ETI SpO2 value was specifically documented in 170 patients (85%) in the study group. In univariate analysis, successful crew ETI was correlated with avoidance of crew-recorded SpO2 value decreasing to < 90% (OR, 0.23; 95% confidence interval, 0.07-0.83). Similarly, requirement for multiple attempts at ETI was correlated with higher likelihood that crews recorded peri-ETI SpO2 value decreasing to < 90% (OR, 7.8; 95% confidence interval, 3.2-18.8). However, in nearly two thirds of cases in which multiple attempts were executed, the peri-ETI SpO2 value remained > 90%. Of the seven patients in whom rescue laryngeal mask airways were placed, the peri-ETI SpO2 value remained > 90% in three (42.9%). CONCLUSION: Documentation of crew-recorded peri-ETI SpO2 nadir is a useful and practical prehospital data point.
机译：目的：研究发现与紧急医疗服务插管（ETI）相关的不良后果，已为院前服务提出了建议，以改善对气道管理过程中氧合的追踪。我们的目标是：1）实施直升机EMS（HEMS）机组的文档要求，要求跟踪和注明HEMS机组ETI期间发生的最低SpO2值（peri-ETI SpO2最低点），以及2）评估与-ETI SpO2文档参数。方法：这是一项在城市HEMS计划中进行的前瞻性研究，其中包括飞行护士/飞行护理人员和协议驱动的护理。在2004年4月至2005年7月之间，连续有200例患者接受了HEMS ETI。单因素logistic回归与比值比（OR）用于评估ETI相关低氧血症（在ETI期间SpO2值降低至<90％）与患者/插管特性。结果：HEMS机组ETI在200例患者中的189例（95.4％）中成功。研究组中有170名患者（85％）明确记录了最低的ETI SpO2最低值。在单变量分析中，成功的机组ETI与避免机组记录的SpO2值降低到<90％相关（OR为0.23; 95％置信区间为0.07-0.83）。同样，多次尝试进行ETI的要求与机组记录ETI SpO2值降低至<90％的可能性更高（OR，7.8; 95％置信区间，3.2-18.8）相关。但是，在执行多次尝试的近三分之二的情况下，peri-ETI SpO2值仍保持> 90％。在放置急救喉罩气道的7例患者中，三分之二的ETI SpO2值仍> 90％（42.9％）。结论：乘员记录的ETI SpO2最低点记录是一个有用且实用的院前数据点。

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