The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

A DIFFICULT AIRWAY RESPONSE TEAM: IMPLEMENTATION AND RT PERCEPTIONS

Georgianna Sergakis1, Rachel Franz1, Sincer K. Jacob1,4, JoAnne P. Trees2, Judy M. Opalek3, Stuart Chow3; 1Respiratory Therapy Division School of Allied Medical Professions, The Ohio State University, Columbus, OH; 2Pulmonary Services, Grant Medical Center, Columbus, OH; 3Trauma Services, Grant Medical Center, Columbus, OH; 4Respiratory Therapy, OSU Medical Center, Columbus, OH

Background: In healthcare institutions across the world, situations arise when patients in a non-critical state need interventions to prevent cardiac arrest, respiratory failure or other critical conditions. In some cases, these potential emergencies may be avoided or at least recognized before they become uncontrollable or lead to fatal outcomes. The implementation of Rapid Response Teams has been shown as effective in addressing such situations. An example of a specialized response team is a Difficult Airway Response Team (DART). The DART is composed of a Physician, Respiratory Therapist (RT), and Registered Nurse that when called, evaluate and secure the airway of patients that have been pre-identified as a difficult airway. The implementation of a DART and perceptions of the RT as part of the team have not been addressed in the research literature. Methods: A retrospective chart review of DART activations explored the implementation of a DART at a level 1 trauma center in an urban metropolitan hospital. In addition, the RT’s role and perceptions regarding the DART were examined. Descriptive statistics were employed to analyze results. Results: After conducting a review of activations, 26% of activations were pre-identified as a difficult airway, 35% had a failed intubation attempt, 11% were considered over triage, and 28% were called for an unknown reason. The total number of intubation attempts required prior to DART activation were decreased following implementation of the DART protocol. There were no activations that resulted in cricothyroidotomy and two activations resulted in tracheostomy. The method of airway placement included use of a Glidescope┬«(13), Video Laryngoscope(1), and Fiberoptic Laryngoscope(11). 56% of patients requiring a DART survived to discharge. The majority of RTs surveyed felt they understood their role in the DART, felt it improved patient outcomes, and agreed they were a valued part of the team and that RT involvement increased interdepartmental respect. Conclusions: The innovative utilization of the DART has improved overall patient safety and the quality of care to patients with difficult airways in a level-1 trauma center. RTs believe they play an integral role and are valuable to the team’s success. The DART allows the RT to be recognized as an important part of the team and has increased collaborative teamwork within the institution. Sponsored Research - None

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