Application of bundle airway management in airway nursing of patients with severe inhalation injury after tracheotomy

Abstract

Objective To explore the effects of bundle airway management on the airway nursing in patients with severe inhalation injury. Methods Totally 32 patients with severe inhalation injury who were admitted and treated in the Department of Burns Surgery, the First Hospital of Jilin University between June 2013 and December 2014 were selected as a control group, who received conventional nursing, while another 35 patients with severe inhalation injury who were admitted and treated from January 2015 to June 2016 were selected as an observation group, who received nursing based on bundle airway management, including airway assessment and emergency treatment, diagnosis and treatment of suffocation, position management, sputum aspiration management, suction under glottis, airway humidification, aerocyst management, nursing with aircasing, nursing of incised part, nursing of breast and chest, mouth care, management of respiratory tube, and infection control in medical environment. Patients in the two groups were evaluated in arterial blood analysis indexes (pH, PaO2, PaCO2, Lac) , oxygenation index and oxygen saturation (SaO2) at day 1, 6 and 12; sputum density in week 2 and 3; and the number of cases with positive results in sputum cultivation in week 2 and 3. Results There were statistically significant differences between the patients in the two groups in pH, PaO2, Lac, PaCO2 and SaO2 values at day 6 (P<0.05) ; oxygenation index at day 12 (P<0.05) ; and sputum density and the positive rate of sputum cultivation in week 2 and 3 (P<0.05) . Conclusions Bundle airway management can effectively improve the oxygenation sputum density in patients with inhalation injury, and reduce their pulmonary infection. Key words: Burns, inhalation; Airway management; Bundle