1. A surgical needs assessment for airway rapid responses: A retrospective observational study.
- Author
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Hynes AM, Lambe LD, Scantling DR, Bormann BC, Atkins JH, Rassekh CH, Seamon MJ, and Martin ND
- Subjects
- Academic Medical Centers statistics & numerical data, Comprehensive Health Care methods, Comprehensive Health Care statistics & numerical data, Emergencies epidemiology, Extracorporeal Membrane Oxygenation statistics & numerical data, Female, Humans, Male, Middle Aged, Needs Assessment, Patient Care Team organization & administration, Pericardiocentesis statistics & numerical data, Time-to-Treatment, United States epidemiology, Airway Management methods, Airway Management standards, Clinical Competence standards, Critical Care methods, Hospital Rapid Response Team organization & administration, Hospital Rapid Response Team standards, Tracheostomy adverse effects, Tracheostomy methods, Tracheostomy statistics & numerical data
- Abstract
Background: Airway rapid response (ARR) teams can be compiled of anesthesiologists, intensivists, otolaryngologists, general and thoracic surgeons, respiratory therapists, and nurses. The optimal composition of an ARR team is unknown but considered to be resource intensive. We sought to determine the type of technical procedures performed during an ARR activation to inform team composition., Methods: A large urban quaternary academic medical center retrospective review (2016-2019) of adult ARR patients was performed. Analysis included ARR demographics, patient characteristics, characteristics of preexisting tracheostomies, incidence of concomitant conditions, and procedures completed during an ARR event., Results: A total of 345 ARR patients with a median age of 60 years (interquartile range, 47-69 years) and a median time to ARR conclusion of 28 minutes (interquartile range, 14-47 minutes) were included. About 41.7% of the ARR had a preexisting tracheostomy. Overall, there were 130 procedures completed that can be performed by a general surgeon in addition to the 122 difficult intubations. These procedures included recannulation of a tracheostomy, operative intervention, new emergent tracheostomy or cricothyroidotomy, thoracostomy tube placement, initiation of extracorporeal membrane oxygenation, and pericardiocentesis., Conclusion: Highly technical procedures are common during an ARR, including procedures related to tracheostomies. Surgeons possess a comprehensive skill set that is unique and comprehensive with respect to airway emergencies. This distinctive skill set creates an important role within the ARR team to perform these urgent technical procedures., Level of Evidence: Epidemiologic/prognostic, level III., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2022
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