美迪醫療網成揚報道說，最近一項研究顯示：在外傷程度相似的情況下，如果腦外傷患者在事故現場接受了緊急氣管插管，他們的預后比那些在送抵醫院后接受插管的患者要差。2004年11月份的《急診醫學年報》(Annals of Emergency Medicine)報道了這項研究成果。

盡管院外氣管插管是一項試圖挽救生命的有價值干預手段，較早期的研究提示這種快速干預造成的不利后果大于有利后果。現在，匹茲堡大學(PA, USA)的研究人員對一項回顧性分析研究做出了結論，研究資料來自2000年～2002年的賓夕法尼亞外傷預后研究項目，研究對象是嚴重頭部外傷的成年患者。

絕大多數此類患者的基本預后是死亡，其次是不同類型的神經性和功能性損害。在4,098例插管患者中，那些在院外接受插管的患者死亡比例要高4倍多。神經性和功能性損害比例同樣高出許多。

“輔助醫務人員，盡管接受過良好培訓，但是他們實踐的機會并不多。他們必須在極其困難的環境下完成操作，并且得不到在醫院里能夠獲得的許多幫助，”匹茲堡大學醫學院急診科副主任、教授Donald M. Yealy醫學博士這樣評論，他也是此文作者之一。“也許這些研究成果提示我們應該重新評介如何處理此類患者。”研究人員指出仍然需要進一步深入研究。

Value of Pre-Hospital Intubation Questioned
 
A study has shown that patients with similar traumatic brain injuries who receive an emergency breathing tube at the scene of an accident have worse outcomes than those who are intubated after arrival at the hospital. The findings were reported in the November 2004 issue of Annals of Emergency Medicine.

While out-of-hospital intubation can be a valuable interventional tool in helping to save lives, earlier studies had suggested that this rapid intervention may be more harmful than helpful. Now, researchers at the University of Pittsburgh (PA, USA) have conducted a retrospective analysis using data obtained from the Pennsylvania Trauma Outcome study between 2000 and 2002, and studied adult patients with severe head injuries.

The primary outcome for most of these patients was death, with secondary outcomes being various types of neurologic and functional impairment. Among the 4,098 patients who were intubated, the odds of death were about four times greater if they were intubated out of the hospital. Neurologic and functional impairment were also greater.

“Paramedics, while very well trained, don’t often have opportunity to perform this procedure, and must attempt it in a difficult environment and without many of the aids available in the hospital,” said Donald M. Yealy, M.D., professor and vice chairman of the department of emergency medicine at the University of Pittsburgh School of Medicine and one of the study’s authors. “Perhaps these findings indicate that we need to reassess how we manage these cases.” The researchers note that additional studies are needed.