Evidence map›Paper›PMID 33062904›Full record

ArticlePediatric quality & safety

Optimizing Rapid Sequence Intubation for Medical and Trauma Patients in the Pediatric Emergency Department.

Berkeley L Bennett, Daniel Scherzer, Delia Gold, Don Buckingham, Andrew McClain, Elaise Hill, Adjoa Andoh, Joseph Christman, Andrew Shonk, Sandra P Spencer

Open access · diamondAbstract read
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Delayed Sequence Intubation in Children, Why Not?Saudi journal of medicine & medical sciences
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Berkeley L BennettDepartment of Pediatrics, Section of Pediatric Emergency Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.
Daniel ScherzerDepartment of Pediatrics, Section of Pediatric Emergency Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.
Delia GoldDepartment of Pediatrics, Section of Pediatric Emergency Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.
Don BuckinghamQuality Improvement Services, Nationwide Children's Hospital, Columbus, Ohio.
Andrew McClainClinical Pharmacy, Nationwide Children's Hospital, Columbus, Ohio.
Elaise HillDepartment of Pediatrics, Division of Emergency Medicine, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Columbus, Ohio.
Adjoa AndohSection of Pediatric Emergency Medicine, Nationwide Children's Hospital, Columbus, Ohio.
Joseph ChristmanRespiratory Care, Nationwide Children's Hospital, Columbus, Ohio.
Andrew ShonkRespiratory Care, Nationwide Children's Hospital, Columbus, Ohio; and.
Sandra P SpencerDepartment of Pediatrics, Section of Pediatric Emergency Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.
Nationwide Children's Hospital · USThe Ohio State University · USChildren's National · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRapid sequence intubation (RSI) is a critical procedure for severely ill and injured patients presenting to the pediatric emergency department (PED). This procedure has a high risk of complications, and multiple attempts increase this risk. We aimed to increase successful intubation within two attempts, focusing on medical and trauma patients separately to identify improvement barriers for each group.

methodsA multifaceted intervention was implemented using quality improvement methods. The analysis included adherence to the standardized process, successful intubation within two attempts, and frequency of oxygen saturations <92% during laryngoscopy. Trauma and medical patients were analyzed separately as team composition differed for each.

resultsThis project began in February 2018, and we included 290 patients between April 2018 and December 2019. Adherence to the standardized process was sustained at 91% for medical patients and a baseline of 55% for trauma patients with a trend toward improvement. In May 2018, we observed and sustained special cause variations for medical patients' successful intubations within two attempts (77-89%). In September 2018, special cause variation was observed and sustained for the successful intubation of trauma patients within two attempts (89-96%). The frequency of oxygen saturation of <92% was 21% for medical patients; only one trauma patient experienced oxygen desaturation.

conclusionImplementation of a standardized process significantly improved successful intubations within two attempts for medical and trauma patients. Trauma teams had more gradual adherence to the standardized process, which may be related to the relative infrequency of intubations and variable team composition.

Identifiers

PMID33062904
PMCPMC7523837
OpenAlexW3090327596

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.