Articles: intubation.
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Emerg Med Australas · Oct 2021
Debriefing immediately after intubation in a children's emergency department is feasible and contributes to measurable improvements in patient safety.
In 2013, our intubations highlighted a safety gap - only 49% achieved first-pass success without hypoxia or hypotension. NAP4 recommended debriefing after intubation, but limited published methods existed. Primary aim is to implement a feasible process for immediate debriefing and feedback for emergency airway management. Secondary aims are to contribute to reduced frequency of adverse intubation-related events and implement qualitative improvements in patient safety through team reflection and feedback. ⋯ Structured and targeted debriefing after intubating children in the ED is feasible and contributes to measurable and qualitative improvements in patient safety.
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Emerg Med Australas · Oct 2021
Observational StudySafety of rapid sequence intubation in an emergency training network.
Rapid sequence intubation (RSI) is a core critical care skill. Emergency medicine trainees are exposed to relatively low numbers of RSIs. We aimed to improve patient outcomes by implementing an RSI checklist, electronic learning and audit, in line with current best evidence. ⋯ Implementation of an evidence-based care bundle and audit of practice has created a safe environment for trainees to learn the core critical care skill of RSI. In our setting, checklist use was associated with fewer complications.
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J Spec Pediatr Nurs · Oct 2021
Comparison of electromagnetic guided imagery to standard confirmatory methods for ascertaining nasogastric tube placement in children.
Evaluate the accuracy of an electromagnetic device (EMD) guided nasogastric tube (NGT) placement compared with standard confirmation methods. A secondary aim was to determine if EMD guided NGT placement would avert potential pulmonary misplacements of the tube. ⋯ EMD guided NGT placement is a potentially viable method for confirming nasogastric tube placement in children when done by appropriately trained clinicians. More research on EMD guided NGT placement in children is needed before any practice recommendation can be made.
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Observational Study
Fewer Tracheal Intubation Attempts are Associated with Improved Neurologically Intact Survival Following Out-of-Hospital Cardiac Arrest.
International guidelines emphasize advanced airway management during out-of-hospital cardiac arrest (OHCA). We hypothesized that increasing endotracheal intubation attempts during OHCA were associated with a lower likelihood of favorable neurologic survival at discharge. ⋯ Increasing number of intubation attempts during OHCA resuscitation was associated with lower likelihood of favorable neurologic outcome.