Reducing the incidence of oxyhaemoglobin desaturation during rapid sequence intubation in a paediatric emergency department.

Journal: BMJ quality & safety
PMID: 26183713

Abstract

OBJECTIVES: Rapid sequence intubation (RSI) is the standard for definitive airway management in emergency medicine. In a video-based study of RSI in a paediatric emergency department (ED), we reported a high degree of process variation and frequent adverse effects, including oxyhaemoglobin desaturation (SpO2<90%). This report describes a multidisciplinary initiative to improve the performance and safety of RSI in a paediatric ED.

Authors

  • Benjamin T Kerrey
    Division of Emergency Medicine and the Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Matthew R Mittiga
    Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Andrea S Rinderknecht
    Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Kartik R Varadarajan
    Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Jenna R Dyas
    Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Gary Lee Geis
    Division of Emergency Medicine and the Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Joseph W Luria
    Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Mary E Frey
    Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Tamara E Jablonski
    Department of Emergency Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Srikant B Iyer
    The Division of Emergency Medicine and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

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