Introducción: muchos de los pacientes que son encontrados fuera del hospital del ámbito hospitalario por el personal sanitario de emergencia con insuficiencia respiratoria grave, requieren una intubación endotraqueal rápida y eficaz que permita disminuir el riesgo de fallecimiento. El objetivo de este estudio es analizar los factores predictivos de intubación endotraqueal difícil (IED) en el medio extrahospitalario. Pacientes y Métodos: se trata de un estudio observacional y retrospectivo. Se analizaron el registro de las asistencias realizadas por el servicio de emergencias médicas de un centro hospitalario de alto nivel entre el periodo 2008-2014 que requirieron intubación endotraqueal Resultados: fueron 402 pacientes a los que se les realizó intubación orotraqueal. La tasa global de éxito fue del 100%. Las variables independientes que se asociaron a una IED fueron: lengua grande en 10 casos (45.5%) p<0.001, apertura bucal limitada 12 casos (54.5%) p<0.001, cuello corto 15 casos (68.2%) p<0.001 y cuello ancho 12 casos (54.5%) p<0.001. Conclusiones: El presentar una apertura bucal limitada, una lengua grande, un cuello corto o ancho y una movilidad cervical limitada se asocian a una intubación endotraqueal difícil en el medio extrahospitalario. Palabras clave: intubación endotraqueal, extra-hospitalaria
SUMMARY:Background: many of the patients who are found outside the hospital by emergency health personnel with severe respiratory insufficiency, require a rapid and effective endotracheal intubation that reduces the risk of death. The objective of this study is to analyze the risk factors of difficult endotracheal intubation (DEI) in the pre-hospital setting. Methods: it is an observational and retrospective study. The assistance performed by the medical emergency service of a high-level hospital center between 2008 and 2014 that required endotracheal intubation was analyzed.Results: there were 402 patients who underwent orotracheal intubation. The independent variables that were associated with an DEI: large tongue in 10 cases (45.5%) p <0.001, limited oral opening 12 cases (54.5%) p <0.001, short neck 15 cases (68.2%) p <0.001 and wide neck 12 cases (54.5%) p <0.001.Conclusions: the presentation of a limited oral opening, a large tongue, a short or wide neck or limited cervical mobility are associated with a difficult endotracheal intubation in prehospital setting.
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