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Improving Simulated Pediatric Airway Management in Community Emergency Departments Using a Collaborative Program With

Samer Abu-Sultaneh1, Travis Whitfill2, Courtney M Rowan3

  • 1Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana. sultaneh@iu.edu.

Respiratory Care
|April 25, 2019
PubMed

Insights

A collaborative program significantly improved pediatric airway management in community emergency departments (CEDs) through simulation and enhanced readiness. This initiative boosted adherence to critical actions and equipment availability, improving patient care quality.

Area of Science:

  • Pediatric Emergency Medicine
  • Quality Improvement Science
  • Healthcare Collaboration

Background:

  • Community emergency departments (CEDs) face challenges in pediatric airway management due to lower patient volume and resource limitations.
  • This often leads to higher mortality rates for pediatric patients compared to academic medical centers (AMCs).
  • A collaborative program was designed to address these disparities.

Purpose of the Study:

  • To evaluate the impact of a collaborative program on pediatric airway management quality in CEDs.
  • To assess improvements in simulated pediatric airway management skills and pediatric emergency readiness scores.

Main Methods:

  • A prospective, pre- and post-intervention study involving 10 CEDs in Indiana.
  • Utilized in situ simulation with a multi-faceted improvement program led by a pediatric AMC.
  • Included post-simulation debriefing, targeted feedback, and resource provision.

Main Results:

  • Overall adherence to a critical action checklist improved from 52% to 71% (P = .003).
  • Significant improvements were noted in endotracheal tube (ETT) size selection, use of cuffed ETTs, and appropriate blade sizing.
  • Pediatric emergency readiness scores increased from 58.8 to 75.8 (P = .01).

Conclusions:

  • A collaborative program between a pediatric AMC and CEDs effectively enhanced simulated pediatric emergency airway management.
  • This model demonstrates potential for improving the management of other pediatric critical conditions in CEDs.
  • The findings highlight the value of inter-institutional collaboration in pediatric emergency care.
Abstract

Keywords:
airway managementcommunity hospitalscommunity outreachhigh-fidelity simulation traininginterprofessionalintubationmultidisciplinarypediatric emergency medicine

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