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Related Experiment Video

Updated: May 5, 2026

Intubation-mediated Intratracheal IMIT Instillation: A Noninvasive, Lung-specific Delivery System
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A Comprehensive Quality Improvement Program to Improve Intubation Performance in Critical Care Transport.

Andrew P Reimer1, Joshua Driscoll2, Lisa Lorenz2

  • 1Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH; Critical Care Transport, Cleveland Clinic, Cleveland, OH.

Air Medical Journal
|March 29, 2025
PubMed
Summary
This summary is machine-generated.

Critical care transport teams improved advanced airway management. A quality improvement initiative significantly boosted first-pass intubation success rates and the Definitive Airway Sans Hypoxia/Hypotension on First Attempt (DASH-1A) metric.

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Area of Science:

  • Emergency Medicine
  • Critical Care Transport
  • Quality Improvement

Background:

  • Advanced airway management is a core competency for critical care transport teams.
  • Performance metrics for airway management can be enhanced through targeted quality improvement initiatives.

Purpose of the Study:

  • To improve first-pass intubation success rates.
  • To enhance the Definitive Airway Sans Hypoxia/Hypotension on First Attempt (DASH-1A) metric.

Main Methods:

  • A multiyear quality improvement initiative utilizing the Plan-Do-Study-Act model.
  • Implementation of best practices including cadaver lab training, airway checklists, and high-fidelity simulation.
  • Prioritized tracking of first-pass intubation success rates and team communication.

Main Results:

  • First-pass intubation success rates increased incrementally from 59% to approximately 95%.
  • The DASH-1A metric showed similar improvement, rising from 59% to 92% annually.
  • Stepwise increases in annual moving averages demonstrated consistent performance gains.

Conclusions:

  • A dedicated quality improvement project effectively enhanced critical care transport team performance in airway management.
  • Focusing on first-pass success and the DASH-1A metric led to sustained improvements over time.