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The Royal North Shore Hospital Emergency Department airway registry: Closing the audit loop
Author(s) -
Fogg Toby,
Alkhouri Hatem,
Vassiliadis John
Publication year - 2016
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12496
Subject(s) - medicine , intubation , observational study , emergency department , emergency medicine , endotracheal intubation , incidence (geometry) , audit , anesthesia , nursing , physics , management , optics , economics
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.