سامانه مدیریت نشریات علمی دانشگاه علوم پزشکی مشهد

Bhatia, Mandip, H, Mohan, Chaudhary, Swapnil, Saroch, Atul, Sharma, Navneet, Sharda, Saurabh. (1404). Impact of a pre-procedural checklist on complications in emergency endotracheal intubation: a prospective cohort study. , 13(3), 153-161. doi: 10.22038/psj.2025.86945.1466
Mandip Singh Bhatia; Mohan Kumar H; Swapnil Chaudhary; Atul Saroch; Navneet Sharma; Saurabh Chandrabhan Sharda. "Impact of a pre-procedural checklist on complications in emergency endotracheal intubation: a prospective cohort study". , 13, 3, 1404, 153-161. doi: 10.22038/psj.2025.86945.1466
Bhatia, Mandip, H, Mohan, Chaudhary, Swapnil, Saroch, Atul, Sharma, Navneet, Sharda, Saurabh. (1404). 'Impact of a pre-procedural checklist on complications in emergency endotracheal intubation: a prospective cohort study', , 13(3), pp. 153-161. doi: 10.22038/psj.2025.86945.1466
Bhatia, Mandip, H, Mohan, Chaudhary, Swapnil, Saroch, Atul, Sharma, Navneet, Sharda, Saurabh. Impact of a pre-procedural checklist on complications in emergency endotracheal intubation: a prospective cohort study. , 1404; 13(3): 153-161. doi: 10.22038/psj.2025.86945.1466

Impact of a pre-procedural checklist on complications in emergency endotracheal intubation: a prospective cohort study

Journal of Patient Safety & Quality Improvement
دوره 13، شماره 3، مهر 2025، صفحه 153-161    اصل مقاله (367.29 K)
نوع مقاله: Original Article
شناسه دیجیتال (DOI): 10.22038/psj.2025.86945.1466
نویسندگان
Mandip Singh Bhatia؛ Mohan Kumar H؛ Swapnil Chaudhary؛ Atul Saroch؛ Navneet Sharma؛ Saurabh Chandrabhan Sharda*
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India -160012.
چکیده
Introduction:
Emergency endotracheal intubation (ETI) is high-risk. Pre-procedural checklists may enhance safety, but evidence in emergency ETI is limited. This preliminary, exploratory study evaluated a checklist's impact on ETI complications and mortality.
 
Materials and Methods:
This prospective cohort study enrolled adult Emergency Department (ED) patients requiring emergency ETI (August 2021-December 2022). A control group (pre-checklist) was compared to an intervention group (post 12-point checklist implementation and training). Data on procedure-related complications and 24-hour mortality were collected and analyzed using relative risks.
 
Results:
131 patients (control n=68, checklist n=63) were included. The overall composite complication rate was similar (RR 1.01, p=0.90), potentially masking individual effects. Checklist use was associated with reduced aspiration (RR 0.36, p=0.045) but an unexpected increase in post-intubation hypoxia (RR 3.24, p=0.004); reasons, possibly procedural delays or altered team dynamics, require further investigation. Other individual complications and 24-hour mortality (RR 1.38, p=0.22) showed no significant differences.
 
Conclusion:
In this underpowered, preliminary, and exploratory study, a pre-procedural checklist did not significantly reduce overall ETI complications. The observed decrease in aspiration alongside increased hypoxia warrants cautious interpretation and underscores the complexity of checklist implementation in emergency airway management. Further research with larger sample sizes is crucial to optimize checklist design and confirm its impact on patient safety.
کلیدواژه‌ها
Endotracheal Intubation؛ Checklist؛ Complications؛ Hypoxia؛ Aspiration؛ Emergency Department؛ Airway Management؛ Exploratory Study
مراجع
  1. Mort TC. The incidence and risk factors for cardiac arrest during emergency tracheal intubation: a justification for incorporating the ASA Guidelines in the remote location. J Clin Anesth. 2004 Nov;16(7):508–16.
  2. Lentz S, Grossman A, Koyfman A, Long B. High-Risk Airway Management in the Emergency Department. Part I: Diseases and Approaches. J Emerg Med. 2020 Jul;59(1):84–95.
  3. Yang TH, Shao SC, Lee YC, Hsiao CH, Yen CC. Risk factors for peri-intubation cardiac arrest: A systematic review and meta-analysis. Biomed J. 2024 Jun 1;47(3):100656.
  4. van Klei WA, Hoff RG, van Aarnhem EEHL, Simmermacher RKJ, Regli LPE, Kappen TH, et al. Effects of the introduction of the WHO “Surgical Safety Checklist” on in-hospital mortality: a cohort study. Ann Surg. 2012 Jan;255(1):44–9.
  5. Clay-Williams R, Colligan L. Back to basics: checklists in aviation and healthcare. BMJ Qual Saf. 2015 Jul 1;24(7):428–31.
  6. Treadwell JR, Lucas S, Tsou AY. Surgical checklists: a systematic review of impacts and implementation. BMJ Qual Saf. 2014 Apr 1; 23(4): 299–318.
  7. Higgs A, McGrath BA, Goddard C, Rangasami J, Suntharalingam G, Gale R, et al. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth. 2018 Feb;120(2):323–52.
  8. Turner JS, Bucca AW, Propst SL, Ellender TJ, Sarmiento EJ, Menard LM, et al. Association of Checklist Use in Endotracheal Intubation with Clinically Important Outcomes: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020 Jul 1;3(7):e209278.
  9. Biau DJ, Kernéis S, Porcher R. Statistics in Brief: The Importance of Sample Size in the Planning and Interpretation of Medical Research. Clin Orthop. 2008 Sep;466(9):2282–8.
  10. Jones S, Carley S, Harrison M. An introduction to power and sample size estimation. Emerg Med J EMJ. 2003 Sep; 20(5): 453–8.
  11. Winters BD, Gurses AP, Lehmann H, Sexton JB, Rampersad CJ, Pronovost PJ. Clinical review: checklists - translating evidence into practice. Crit Care Lond Engl. 2009;13(6):210.
  12. Steel A, Haldane C, Cody D. Impact of videolaryngoscopy introduction into prehospital emergency medicine practice: a quality improvement project. Emerg Med J EMJ. 2021 Jul; 38(7):549–55.
  13. Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med. 2001 Mar 1; 344(9):665–71.
  14. Benumof JL. Preoxygenation: best method for both efficacy and efficiency. Anesthesiology. 1999 Sep;91(3):603–5.
  15. Prakash S, Rapsang AG, Mahajan S, Bhattacharjee S, Singh R, Gogia AR. Comparative Evaluation of the Sniffing Position with Simple Head Extension for Laryngoscopic View and Intubation Difficulty in Adults Undergoing Elective Surgery. Anesthesiol Res Pract. 2011; 2011: 297913.
 

 

 

 

 

 

 

 

 

  1. Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006 Dec 28;355(26):2725–32.
  2. Bodily JB, Webb HR, Weiss SJ, Braude DA. Incidence and Duration of Continuously Measured Oxygen Desaturation During Emergency Department Intubation. Ann Emerg Med. 2016 Mar 1;67(3):389–95.
  3. Pourmand A, Robinson C, Dorwart K, O’Connell F. Pre-oxygenation: Implications in emergency airway management. Am J Emerg Med. 2017 Aug 1;35(8):1177–83.
  4. McKown AC, Casey JD, Russell DW, Joffe AM, Janz DR, Rice TW, et al. Risk Factors for and Prediction of Hypoxemia during Tracheal Intubation of Critically Ill Adults. Ann Am Thorac Soc. 2018 Nov;15(11):1320–7.
  5. Urbach DR. The Checklist Paradox. Ann Surg. 2017 Dec;266(6):930–1.
  6. Sakles JC. Maintenance of Oxygenation During Rapid Sequence Intubation in the Emergency Department. Acad Emerg Med. 2017; 24(11): 1395–404.
  7. Taryle DA, Chandler JE, Good JT, Potts DE, Sahn SA. Emergency room intubations--complications and survival. Chest. 1979 May; 75(5): 541–3.
  8. Sheikh S, Shamim F. Video Laryngoscopy in Emergency Airway Management - a Paradigm Shift from ‘I’ to ‘We’; a Letter to Editor. Arch Acad Emerg Med. 2022 Mar 20;10(1):e22.
  9. Nagler J, Krauss B. Capnography: a valuable tool for airway management. Emerg Med Clin North Am. 2008 Nov;26(4):881–97, vii.
آمار
تعداد مشاهده مقاله: 182
تعداد دریافت فایل اصل مقاله: 123