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Studying the Safety and Performance of Rapid Sequence Intubation: Data Collection Method Matters
Andrea S Rinderknecht1,2, Jenna R Dyas1, Benjamin T Kerrey1,2
1Department of Pediatrics, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Summary
Video review offers a more comprehensive data source than chart review for studying pediatric emergency department rapid sequence intubation (RSI), capturing more adverse events and process details.
Area of Science:
- Emergency Medicine
- Medical Education
- Patient Safety
Background:
- Rapid sequence intubation (RSI) is a critical procedure in emergency departments.
- Accurate data collection is essential for evaluating and improving RSI practices.
- Existing studies often rely on retrospective chart review, which may have limitations.
Purpose of the Study:
- To compare the effectiveness of chart review versus video review for collecting data on pediatric emergency department (ED) rapid sequence intubation (RSI).
- To identify discrepancies in outcome and process data between the two methods.
Main Methods:
- A retrospective cohort study analyzed 12 months of pediatric ED RSI cases.
- Data on adverse effects, process components, and timing were extracted from both chart and video records.
- Key outcomes included desaturation, vomiting, laryngoscopy attempts, and preoxygenation duration.
Main Results:
- Video review identified significantly higher rates of adverse effects (67%) compared to chart review (46%).
- Desaturation rates were nearly double when assessed via video (34%) versus chart (18%).
- Video review provided more reliable and detailed data on RSI process performance and timing.
Conclusions:
- Chart review significantly underestimates adverse events and inconsistently captures critical process data for RSI studies.
- Video review offers a superior data source for retrospective analysis of pediatric ED RSI.
- Future research designs should consider the limitations of chart data and prioritize higher-quality sources like video review.
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