The Clinical Value Of A Simple Airway Algorithm In Rapid Sequence Intubation

Objectives To explore the clinical values of a simple airway algorithm in rapidsequence intubation.Methods The medical records of9251cases undergoing general anesthesia withrapid sequence intubation from January2005to December2012were analyzedretrospectively. According to the stage of the simple airway management algorithm applied,the data were divided into two groups, group A was4214cases who the simple algorithm inrapid sequence intubation applied from January2009to December2012, group B was5037cases who the simple algorithm in rapid sequence intubation didn’t applied from January2005to December2008. The ratio of airway management approach in group A was analysis. Thekappa test was used to determine adherence to the predefined initial approach. Thecomposition of endotracheal intubation solutions in a laryngeal view class III～IV in groupA and group B were compared using2×C table of chi-square test.Results1.Serious hypoxia, brain injury and cardiac arrest caused by endotrachealintubation had never take place in group A. There was10.87%(458/4214) airway problems ingroup A, mask ventilation problems was3.70%(156/4214): both hands mask ventilationaccount for8.98%(14/156), oropharyngeal airway combine with mask ventilation account for89.74%（140/156）, laryngeal mask airway account for1.28%(2/156), intubation problemswas7.17%(302/4214): oral blind intubation was33.44%(102/302), gum elastic bougieintubation was62.26%(188/302), McCoy laryngoscope intubation was3.97%(12/302), fiberbronchoscope intubation was0.33%(1/302).2. Kappa value which determine the coherencebetween mask ventilation problems and prefer oropharyngeal airway was0.95, Kappa value which determine coherence between intubation problems and prefer gum elastic bougie was0.95.3. The ratio of glottis view Ⅲ~Ⅳ in group A was6.12%(258/4214), group B6.83%(344/5037), they had no statistical difference between the two groups (P>0.05).Intubationmethod of the glottis view Ⅲ~Ⅳhave statistically significant between the two groups (P <0.01): the rate of gum elastic bougie in group A intubation was56.20%(145/258), group B40.40%(139/344), the two groups was statistically difference (P <0.05); oral blind intubationof group A is39.15%(101/258), group B50.58%(174/344), the two groups was statisticallydifference (P <0.05); The rate of other methods in group A was4.65%(12/258), group B9.01%(31/344), the two groups was statistically difference (P <0.05).Conclusion The simple airway algorithm has clinical value.