2010 OPEN FORUM Abstracts
ANNUAL AIRWAY WORKSHOPS FOR RESPIRATORY THERAPISTS AND PHYSICIANS PROVIDE A STANDARD APPROACH TO LEARNING NEW PRODUCTS AND DEVICES AND MAY BE A COMPONENT FOR PERFORMANCE IMPROVEMENT IN AIRWAY PLACEMENTS IN A HOSPITAL.
John T. Murphy, Robert G. Shellman; Respiratory Therapy, St Francis Hospital, Indianapolis, IN
Background: MDs and RTs learn clinical competency with airway placement and proficiency with advanced techniques for emergencies since failure to place a required airway can be fatal. These clinicians train for airway placement differently yet perform similarly. Hospitals get airway devices and equipment, but no shared standard training exists for MDs and RTs. Performance Improvement (PI) for airway placement in 2007 by RT in 2 attempts was not optimal. Method: Chief Medical Officer (CMO) and RT leadership held an Airway Workshop (AW) in 2008 and 2009 with good results. Training stations with manikins featured items used in code carts and difficult airway drawers. RT instructors reviewed NRP, PALS, and ACLS guidelines and hospital policies to offer hands on educational opportunity to participants. Infant, pediatric and adult ET tube insertion was taught with manual and videolaryngoscopes. ET tube insertion through an LMA was taught. Difficult airway items included disposable optical laryngoscopes, emergency cricothyrotomy, retrograde intubation, tube exchangers, intubating stylettes, and percutaneous tracheotomy. Laryngectomy and tracheotomy tube replacement was presented with cuff management. Participants practiced intubating by fiberoptic bronchoscopy. Results: There were scheduled times for MDs, RTs and a general session. Attendees included internists, pulmonologists, pediatricians, anesthesiologists, and emergency and family practice doctors. AW evaluations were positive. Results for departmental PI of airway placement by RT in 2 attempts or less did improve after the second AW. 2007 PI showed RT success at 88.6% in 2 attempts or less. 2009 RT PI showed 4% improvements to 92.6%. Attempts per airway placed remained at 1.4 for RT and 1.7 for MDs while bringing more hospital beds online in this time. RT intubators increased between 2007 and 2009 from 34 to 42. RT Proficiency OR Intubation Program was improved and the hospital acquired new equipment in 2008 and 2009. Conclusion: AW for RT and MDs offer a standard approach to learning new products and devices. Participants worked to build teamwork and satisfaction and the number of RT intubators increased. AW may be a component for improving airway placement PI along with acquiring new equipment and improvements to the RT Proficiency OR Intubation Program. The AW promotes RT instructors as airway specialists who help doctors and peers improve airway placements. Sponsored Research - None Established Airways Data for RT and MDs; Attempts/Airway Placed