Development of a standard operating procedure and checklist for rapid sequence induction in the critically ill

Sherren, Peter B.; Tricklebank, Stephen; Glover, Guy

doi:10.1186/s13049-014-0041-7

Cited by 52 publications

(50 citation statements)

References 59 publications

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“…An algorithm for airway management (Appendix S2) was developed by consensus among the EPs in our department, and while based on the Difficult Airway Society's guidelines, it was tailored for use within our ED. Our objective was to try and standardise airway planning, thus enabling the resuscitation team to function more efficiently and more safely . A pre‐RSI checklist (Appendix S3) was also developed using Delphi methodology among the EPs at our institution and then the ED Directors of NSW (unpublished study).…”

Section: Discussionmentioning

confidence: 99%

The Royal North Shore Hospital Emergency Department airway registry: Closing the audit loop

Fogg

Alkhouri²,

Vassiliadis

2015

Emerg Medicine Australasia

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Objective We aim to investigate whether a bundle of changes made to the practice of endotracheal intubation in our ED was associated with an improvement in first pass success rate and a reduction in the incidence of complications. Methods We used a prospective observational study. Results The data on 360 patients who were intubated during an 18‐month period following the introduction of these changes were compared with our previously published observational data. Success on first attempt at intubation improved 83.4% to 93.9% (P < 0.0001). The proportion of patients with one or more complication fell from 29.0% to 19.4% (P < 0.042). Oesophageal intubation fell from 4.0% to 0.3% (P < 0.001), and there was a non‐significant reduction in the rate of desaturation, from 15.6% to 10.9% (P < 0.07). Conclusion We have shown that, through the introduction of a bundle of changes that spans the domains of staff training, equipment and practice standardisation, we have made significant improvements in the safety of patients undergoing endotracheal intubation in our ED.

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Section: Discussionmentioning

confidence: 99%

The Royal North Shore Hospital Emergency Department airway registry: Closing the audit loop

Fogg

Alkhouri²,

Vassiliadis

2015

Emerg Medicine Australasia

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“…Standardisation of the procedure6 through the use of checklists and standard operating procedures (SOPs) can improve the safety and effectiveness of PHEA 7. The purpose of a checklist is to improve the performance of a complex procedure by providing a reminder of the most critical and important steps 8.…”

Section: Introductionmentioning

confidence: 99%

Prehospital emergency anaesthesia: an updated survey of UK practice with emphasis on the role of standardisation and checklists

et al. 2018

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“…A standard operating procedure for ETI [19], such as unified DAM equipment set-up, pre-ETI assessment, and post-intubation care with end-tidal CO 2 detection, has not yet been established in our ED.…”

Section: Methodsmentioning

confidence: 99%

Association between off-hour presentation and endotracheal-intubation-related adverse events in trauma patients with a predicted difficult airway: A historical cohort study at a community emergency department in Japan

Ono

Sugiyama

Chida

et al. 2016

Scand J Trauma Resusc Emerg Med

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BackgroundA reduction in medical staff such as occurs in hospitals during nights and weekends (off hours) is associated with a worse outcome in patients with several unanticipated critical conditions. Although difficult airway management (DAM) requires the simultaneous assistance of several appropriately trained medical caregivers, data are scarce regarding the association between off-hour presentation and endotracheal intubation (ETI)-related adverse events, especially in the trauma population. The aim of this study was to determine whether off-hour presentation was associated with ETI complications in injured patients with a predicted difficult airway.MethodsThis historical cohort study was conducted at a Japanese community emergency department (ED). All patients with inhalation burn, comminuted facial trauma (Abbreviated Injury Scale Score Face ≥3), and penetrating neck injury who underwent ETI from January 2007 to January 2016 in our ED were included. Primary exposure was off-hour presentation, defined as the period from 6:01 PM to 8:00 AM weekdays plus the entire weekend. The primary outcome measure was the occurrence of an ETI-related adverse event, including hypoxemia, unrecognized esophageal intubation, regurgitation, cardiac arrest, ETI failure rescued by emergency surgical airway, cuff leak, and mainstem bronchus intubation.ResultsOf the 123 patients, 75 (61.0 %) were intubated during off hours. Crude analysis showed that off-hour presentation was significantly associated with an increased risk of ETI-related adverse events [odds ratio (OR), 2.5; 95 % confidence interval (CI), 1.1–5.6; p = 0.033]. The increased risk remained significant after adjusting for potential confounders, including operator being an anesthesiologist, use of a paralytic agent, and injury severity score (OR, 3.0; 95 % CI, 1.1–8.4; p = 0.034).ConclusionsIn this study, off-hour presentation was independently associated with ETI-related adverse events in trauma patients with a predicted difficult airway. These data imply the need for more attentive hospital care during nights and weekends.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-016-0296-2) contains supplementary material, which is available to authorized users.

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Development of a standard operating procedure and checklist for rapid sequence induction in the critically ill

Cited by 52 publications

References 59 publications

The Royal North Shore Hospital Emergency Department airway registry: Closing the audit loop

The Royal North Shore Hospital Emergency Department airway registry: Closing the audit loop

Prehospital emergency anaesthesia: an updated survey of UK practice with emphasis on the role of standardisation and checklists

Association between off-hour presentation and endotracheal-intubation-related adverse events in trauma patients with a predicted difficult airway: A historical cohort study at a community emergency department in Japan

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