Pediatric Tracheostomy Emergency Readiness Assessment Tool: International Consensus Recommendations

Abstract

ObjectiveTo achieve consensus on critical steps and create an assessment tool for actual and simulated pediatric tracheostomy emergencies that incorporates human and systems factors along with tracheostomy‐specific steps.MethodsA modified Delphi method was used. Using REDCap software, an instrument comprising 29 potential items was circulated to 171 tracheostomy and simulation experts. Consensus criteria were determined a priori with a goal of consolidating and ordering 15 to 25 final items. In the first round, items were rated as “keep” or “remove”. In the second and third rounds, experts were asked to rate the importance of each item on a 9‐point Likert scale. Items were refined in subsequent iterations based on analysis of results and respondents' comments.ResultsThe response rates were 125/171 (73.1%) for the first round, 111/125 (88.8%) for the second round, and 109/125 (87.2%) for the third round. 133 comments were incorporated. Consensus (>60% participants scoring ≥8, or mean score >7.5) was reached on 22 items distributed across three domains. There were 12, 4, and 6 items in the domains of tracheostomy‐specific steps, team and personnel factors, and equipment respectively.ConclusionsThe resultant assessment tool can be used to assess both tracheostomy‐specific steps as well as systems factors affecting hospital team response to simulated and clinical pediatric tracheostomy emergencies. The tool can also be used to guide debriefing discussions of both simulated and clinical emergencies, and to spur quality improvement initiatives.Level of EvidenceLevel 5 Laryngoscope, 2023

Validation of a Novel Mobile Application for Assessing Pediatric Tracheostomy Emergency Simulations

“…Critical action steps to perform during the in situ simulations were selected by the study team through discussion and review of published international consensus recommendations for pediatric tracheostomy emergency readiness. 36 , 37 , 38 Action steps were selected with consideration to both their importance and feasibility of observation during simulation. Data definitions were developed to standardize assessment.…”

“…Actions included in the application are based on international consensus recommendations regarding the most critical components (“steps”), of an emergent tracheostomy change. 36 This study aims to establish accuracy and reliability of the NeoCHART+ TM for PEAK‐II mobile application for evaluating team performance of critical steps during simulated pediatric tracheostomy emergencies.…”