In an important quality initiative for AED, Dr Fen Moy (ED Specialist) has recently launched an airway registry to gather data on endotracheal intubation in the emergency department. The results will be used to improve clinical care and training:
The Adult Emergency Department Airway Register
Reason for Establishing an Airway Register:
Currently AED does not have any records of the number of intubations done in the department. Nor is there any information about the indications, which staff are performing the intubations, difficulties encountered, and complications occurring.
Emergency Medicine Australasia published a prospective observational study of the airway register used in Royal North Shore Hospital in Sydney. It was the first descriptive study of intubations in an Australasian ED. It highlighted the lack of information of intubations done in Australasian EDs. There has been more information from North America with the establishment of an online National Emergency Airway Registry since 1996 (however it only has 25 participating hospitals).
Benefits of an Airway Register:
1. The register will provide objective data for AED & DCCM regarding numbers of intubations done in AED.
2. Collected information which can lead to quality improvement for AED and other departments. Specifically: frequency of complications; experience & success rates of intubators; need for rescue devices; need for Airway Emergency Team call-outs.
3. This can then be used for further education & training of staff.
It would be expected that the intubator will be responsible for filling out the form, particularly the sections highlighted #. The forms are on the side of each Resus bay’s write-up platform, and the completed forms can be placed in the adjacent plastic sleeve.
The team leaders – please remind the intubator to fill in the form.
Results of the register will be analysed and fedback to AED during Clinical Governance sessions, as well as to the Department of Anaesthesia and the DCCM. We are using this registry within AED currently, but may look at joining the Australasian Registry at some stage in the future for wider collaboration.
Dr Fen Moy
Current version of AED airway registry (click to enlarge):
Minh Le Cong from Prehospitalmed.com recently interviewed Dr Toby Fogg, the author of the airway registry study referenced above, and released it as an audio podcast. The podcast, which contains discussion around the the results of the study plus airway registries in general, RSI checklists, airway skills maintenance, video laryngoscopy, and criciod pressure is here. Minh Le Cong’s podcast page, with references, is here.