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Development of a Multidisciplinary Pediatric Airway Program: An Institutional Experience

Authors :
Renee Cover
Nicholas M. Dalesio
Lynette Mark
Natalia M. Diaz-Rodriguez
Robert H. Brown
David E. Tunkel
Sapna R. Kudchadkar
Sara I. Jones
Rahul Koka
Vinciya Pandian
Source :
Hospital Pediatrics. 9:468-475
Publication Year :
2019
Publisher :
American Academy of Pediatrics (AAP), 2019.

Abstract

Rapid response teams have become necessary components of patient care within the hospital community, including for airway management. Pediatric patients with an increased risk of having a difficult airway emergency can often be predicted on the basis of clinical scenarios and medical history. This predictability has led to the creation of airway consultation services designed to develop airway management plans for patients experiencing respiratory distress and who are at risk for having a difficult airway requiring advanced airway management. In addition, evolving technology has facilitated airway management outside of the operating suite. Training and continuing education on the use of these tools for airway management is imperative for clinicians responding to airway emergencies. We describe the comprehensive multidisciplinary, multicomponent Pediatric Difficult Airway Program we created that addresses each component identified above: the Pediatric Difficult Airway Response Team (PDART), the Pediatric Difficult Airway Consult Service, and the pediatric educational airway program. Approximately 41% of our PDART emergency calls occurred in the evening hours, requiring a specialized team ready to respond throughout the day and night. A multitude of devices were used during the calls, obviating the need for formal education and hands-on experience with these devices. Lastly, we observed that the majority of PDART calls occurred in patients who either were previously designated as having a difficult airway and/or had anatomic variations that suggest challenges during airway management. By instituting the Pediatric Difficult Airway Consult Service, we have decreased emergent Difficult Airway Response Team calls with the ultimate goal of first-attempt intubation success.

Details

ISSN :
21541671 and 21541663
Volume :
9
Database :
OpenAIRE
Journal :
Hospital Pediatrics
Accession number :
edsair.doi.dedup.....88f7a0c9b3cc3ac117bbd844e9dd3d19
Full Text :
https://doi.org/10.1542/hpeds.2018-0226