Design and Implementation of Airway Response Teams to Improve the Practice of Emergency Airway Management

Tankard, Kelly A.; Sharifpour, Milad; Chang, Marvin G.; Bittner, Edward A.

doi:10.3390/jcm11216336

Cited by 10 publications

(2 citation statements)

References 77 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, prevention of airway obstruction and adequate preoxygenation with or without assisted ventilation and monitoring are useful. [19,[24][25][26] The initial management was described in the Code D-delta instruction worksheet (Fig. 2).…”

Section: Discussionmentioning

confidence: 99%

Difficult airway code activation for emergency endotracheal intubation outside the operating room in a tertiary care university hospital of Thailand: A single-center retrospective observational study

Buasuk,

Khongcheewinrungruang,

Suphathamwit

2023

Medicine

View full text Add to dashboard Cite

Emergency airway management outside the operating room (OR) is a higher risk procedure as compared to the OR setting. Inappropriate airway management leading to complications, including pulmonary aspiration, dental trauma, esophageal intubation, prolonged recovery, unplanned intensive care unit admission and death. The emergency difficult airway management team of Siriraj hospital has been established since 2018 under the name of Code-D delta. The aim of this study is to determine the rate of Code D-delta activation, the performance of the code, the complications and outcome of the patients. This is a single-centered, observational, and retrospective study included all adult patient who was emergency intubated outside the OR between July and November 2020. The criteria for code D-delta activation included failed intubation for more than 2 attempts and suspected difficult intubation. The collected data were categorized into Code D-delta activation and non-activation group. The primary outcome was a frequency of Code D-delta activation. The demographic data, ward and indication of activation, intubation process, the complications of intubation were also collected and analyzed. During the study period, 247 patients with 307 intubations were included. The incidence of code D-delta activation was 8.14%. Regarding indication of activation, failed intubation more than 2 attempts was 40%, while suspected difficult intubation was 92%. Respiratory failure was the highest main diagnosis at 36%. The highest rate of activation was from medicine ward (60%), followed by surgery ward (16%) and emergency department (16%). Regarding the code responses and intubation performance, 7 and 10 minutes were the median time from call to scene in- and out- of official hours. The success rate of intubation at scene by code D-delta team was 85%. The airway and other complications were comparable between groups. This is the first study about emergency difficult airway management team in university hospital of Thailand. This study showed the rate of Code-D delta activation, the emergency airway management code, was 8.14% with the success rate of 85% at scene. Emergency airway management outside the operating room is particularly challenging. Airway assessment, planning, decision making of the team relevant to the patients outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Difficult airway code activation for emergency endotracheal intubation outside the operating room in a tertiary care university hospital of Thailand: A single-center retrospective observational study

Buasuk,

Khongcheewinrungruang,

Suphathamwit

2023

Medicine

View full text Add to dashboard Cite

show abstract

“…Intubation-related adverse events are associated with a lack of a systematic approach [24]. Airway teams and in situ simulation have been suggested in pre-COVID intubation guidelines to decrease these adverse events [24][25][26]. Unsurprisingly, guidelines and observational studies published during the pandemic encouraged a structured and systematic process [27][28][29].…”

Section: Previous Studies Team Structures Simulationmentioning

confidence: 99%

Characterizing intubation practices in response to the COVID-19 pandemic: a survey of the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) sites

Ismath,

Black,

Hrymak

et al. 2023

BMC Emerg Med

View full text Add to dashboard Cite

Objective The risk of occupational exposure during endotracheal intubation has required the global Emergency Medicine (EM), Anesthesia, and Critical Care communities to institute new COVID- protected intubation guidelines, checklists, and protocols. This survey aimed to deepen the understanding of the changes in intubation practices across Canada by evaluating the pre-COVID-19, early-COVID-19, and present-day periods, elucidating facilitators and barriers to implementation, and understanding provider impressions of the effectiveness and safety of the changes made. Methods We conducted an electronic, self-administered, cross-sectional survey of EM physician site leads within the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) to characterize and compare airway management practices in the pre-COVID-19, early-COVID-19, and present-day periods. Ethics approval for this study was obtained from the University of Manitoba Health Research Ethics Board. The electronic platform SurveyMonkey (www.surveymonkey.com) was used to collect and store survey tool responses. Categorical item responses, including the primary outcome, are reported as numbers and proportions. Variations in intubation practices over time were evaluated through mixed-effects logistic regression models. Results Invitations were sent to 33 emergency department (ED) physician site leads in the CCEDRRN. We collected 27 survey responses, 4 were excluded, and 23 analysed. Responses were collected in English (87%) and French (13%), from across Canada and included mainly physicians practicing in mainly Academic and tertiary sites (83%). All respondents reported that the intubation protocols used in their EDs changed in response to the COVID-19 pandemic (100%, n = 23, 95% CI 0.86-1.00). Conclusions This study provides a novel summary of changes to airway management practices in response to the evolving COVID-19 pandemic in Canada. Information from this study could help inform a consensus on safe and effective emergent intubation of persons with communicable respiratory infections in the future.

show abstract

Guía de la Sociedad Española De Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR), Sociedad Española de Medicina de Urgencias y Emergencias (SEMES) y Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello (SEORL-CCC) para el manejo de la vía aérea difícil. Parte II

Gómez-Ríos,

Sastre,

Onrubia-Fuertes

et al. 2024

Revista Española de Anestesiología y Reanimación

View full text Add to dashboard Cite

Design and Implementation of Airway Response Teams to Improve the Practice of Emergency Airway Management

Cited by 10 publications

References 77 publications

Difficult airway code activation for emergency endotracheal intubation outside the operating room in a tertiary care university hospital of Thailand: A single-center retrospective observational study

Difficult airway code activation for emergency endotracheal intubation outside the operating room in a tertiary care university hospital of Thailand: A single-center retrospective observational study

Characterizing intubation practices in response to the COVID-19 pandemic: a survey of the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) sites

Contact Info

Product

Resources

About