TY  - BOOK
AU  - Himmler, Amber
AU  - Johnson, Laura
AU  - Mcdermott, Chelsea
AU  - Rhoades, Emily
AU  - Trankiem, Christine
TI  - Code Critical Airway: A Collaborative Solution to a Catastrophic Problem
SN  - 0003-1348
PY  - 2022///
KW  - IN PROCESS -- NOT YET INDEXED
KW  - MedStar Washington Hospital Center
KW  - MedStar General Surgery Residency
KW  - MedStar Georgetown University Hospital/MedStar Washington Hospital Center
KW  - Surgery/Burn Services
KW  - Surgery/Surgical Critical Care
KW  - Surgery/Trauma Surgery
KW  - Journal Article
N1  - Available online through MWHC library: 2005 - present, Available in print through MWHC library:1999-2007
N2  - BACKGROUND: In 2006, a multi-disciplinary "Code Critical Airway" (CCA) Team was created at our institution. The objective of this study is to examine the demographics and outcomes of the patients for whom a CCA is activated; CONCLUSION: Inculcation of aggressive early escalation of airway emergencies through implementation of a CCA Team has resulted in significant improvement in first attempt airway stabilization and a decrease in surgical airways; METHODS: A retrospective review was conducted of patients for whom a CCA was activated from 2008-2020. Data from 2006-2008 was not available due to timing of the implementation of the hospital's electronic medical record system. The early period of the experience with CCAs (2008-2014) was compared to the later period (2015-2020) CCA activations; RESULTS: There were 953 CCA activations. Over time, there was a statistically significantly increase in the number of CCA activations. CCAs occurred in the emergency department in 274 (29.0%), intensive care unit in 255 (27.0%), step-down unit in 60 (6.4%), wards in 294 (31.1%), and elsewhere in 61 (6.5%) cases. CCAs were managed with direct laryngoscopy in 97 patients (10.2%), video laryngoscope in 160 patients (16.8%), fiberoptic bronchoscopy in 179 patients (18.8%), bougie in 7 patient (0.7%), replacement of a prior tracheostomy in 262 patients (27.5%), and creation of a new surgical airway in 95 patients (10.0%). The definitive management of the CCA was not recorded in 76 patients (8.0%). Seven patients required removal of a foreign body (0.7%). There was no intervention in 70 patients (7.3%). There was an increase in successful first attempts at obtaining an airway comparing our experience in the early period (2008-2014) compared to the later period (2015-2020) (P < 0 .001). There was also a decrease in number of CCAs requiring a surgical airway (P = .030)
UR  - https://dx.doi.org/10.1177/00031348221101485
ER  -