[Adequate respiratory therapy in polytrauma in the prehospital phase by pulse oximetry monitoring].
As a result of recent medical development, the pulse oximetry enables the emergency-doctor to carry out an objective and continuous respiratory monitoring. In a prospective study we showed the consequences of this new procedure for prehospital respiratory therapy and the following posttraumatic development of polytraumatized patients. In 1988 within 6 months we carried out a continuous monitoring of 13 severely polytraumatized patients in the prehospital period using the pulse oximeter Nellcor N-10 and Pulsat. In order to see the posttraumatic respiratory complications, we studied the respiratory therapy of the following 3 days as well as the course of disease until the patients' release of the hospital. 38% of the patients were intubated immediately after the accident and further 12% before arriving at the hospital. The oxygen inhalation therapy of 63% spontaneously breathing patients and the mechanical ventilation patterns of 80% of the ventilated patients were modified in the prehospital period, because 60% of the patients with standard mechanical ventilation showed hypoxygenations. During the first 3 posttraumatic days 23% of the patients died the the number of mechanical ventilated patients increased from 46% to 54% because of surgical interventions. A respiratory therapy of more than 3 days was applied on 40% of the surviving patients, with 20% receiving mechanical ventilation. Thereby no primarily respiratory complications could be seen. While not being decisive for immediate intubation, monitoring with a pulse oximeter used by the emergency-doctor plays an essential part in carrying out an effective control and dosage of the therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Gust
R
R
Klinik für Ansthesiologie Universität Heidelberg.
Walz
T
T
Frobenius
H
H
Krier
C
C
D000293:Adolescent; D000328:Adult; D003422:Critical Care / Q000379:methods*; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000628:therapy*; D010092:Oximetry / Q000295:instrumentation*; D010102:Oxygen Inhalation Therapy; D010865:Pilot Projects; D011175:Positive-Pressure Respiration; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D014187:Transportation of Patients
Adäquate respiratorische Therapie beim Polytrauma in der prähospitalen Phase durch pulsoximetrisches Monitoring.