Our new version of the emergency induction checklist:
now incorporating "NO DESAT and THRIVE"....
Tuesday 17 March 2015
Monday 17 November 2014
Should Real Airway Experts Use Checklists?
A great argument here from Dr Tim Leeuwenburg who presented at smaccGOLD in March 2014 on the subject "Should Real Airway Experts Use Checklists?". Highly recommended reading.
Sunday 16 June 2013
Welcome to the emergency intubation / rapid sequence intubation checklist blog
In 2012, in response to the findings of the 4th national audit project of the Royal College of Anaesthetists of Great Britain (NAP4), Ysbyty Gwynedd in Bangor, North Wales developed a checklist to be used by staff prior to all emergency intubations / rapid sequence inductions in the ICU / ITU and emergency department (ER).
We have validated and audited the checklist and have it is now a standard practice in Ysbyty Gwynedd. We have developed some training presentations and a training video (on you tube) which we are happy to share freely through this blog. The checklist is adapted from one published in NAP4. The checklist we use is also available on this blog. Please feel free to browse and use these.
No matter how experienced or senior you are, you are human and prone to lapses and error. We all forget basic things occasionally under duress. Most of the time the consequences are insignificant but during an emergency intubation the consequences of forgetting to consider a back up plan, or forgetting the capnograph could result in disaster. A simple checklist is free and simple to follow. It doesn't need to be time consuming or patronising. In fact we spent a lot of time working on the checklist to make sure it was user friendly. (The version we adopted was about the 10th version.)
If your hospital / department are not currently using any form of verbal checklist for emergency intubations - why not? Are you confident that all your emergency intubations are perfect? Do you think there could be room for improvement? To quote Atul Gawande "Better is possible. It doesn't take genius, it takes diligence"
Take our checklist - adopt it for your own hospital / department and start using it.
We have validated and audited the checklist and have it is now a standard practice in Ysbyty Gwynedd. We have developed some training presentations and a training video (on you tube) which we are happy to share freely through this blog. The checklist is adapted from one published in NAP4. The checklist we use is also available on this blog. Please feel free to browse and use these.
No matter how experienced or senior you are, you are human and prone to lapses and error. We all forget basic things occasionally under duress. Most of the time the consequences are insignificant but during an emergency intubation the consequences of forgetting to consider a back up plan, or forgetting the capnograph could result in disaster. A simple checklist is free and simple to follow. It doesn't need to be time consuming or patronising. In fact we spent a lot of time working on the checklist to make sure it was user friendly. (The version we adopted was about the 10th version.)
If your hospital / department are not currently using any form of verbal checklist for emergency intubations - why not? Are you confident that all your emergency intubations are perfect? Do you think there could be room for improvement? To quote Atul Gawande "Better is possible. It doesn't take genius, it takes diligence"
Take our checklist - adopt it for your own hospital / department and start using it.
Thursday 13 June 2013
Abstract published in Anaesthesia 2013, 68, 655-661.
Our emergency induction checklist is now a standard practice for all emergency intubations in the emergency department and HDU / ITU here at Ysbyty Gwynedd in Bangor, North Wales.
A recent audit found that most users find that it is very helpful and does not significantly delay the intubations.
I am also glad to hear that it the you tube video that we made has been used for mandatory training in the Gold Coast Hospital, Queensland, Australia (where oddly enough I used to work in 2002). Great minds think alike!
We have also had an abstract published after our poster was shortlisted at the DAS conference last November. The abstract can be accessed via the anaesthesia online website:
http://onlinelibrary.wiley.com/store/10.1111/anae.12174/asset/anae12174.pdf?v=1&t=hhwfr0i7&s=e9b27535df47c3657d67c6502595391ba7941fa0
Monday 12 November 2012
Poster for Difficult Airway Society Conference
Poster for presentation of our emergency induction checklist study at the annual conference of the Difficult Airway Society, Cardiff (21st-23rd November 2012) by Dr Farbod Babolhavaeji (ACCS CT2 trainee in Emergency Medicine)
Friday 22 June 2012
2nd Prize at Welsh Intensive Care Society
The Emergency Induction Checklist was well received at the annual summer scientific meeting of the Welsh Intensive Care Society in Saundersfoot, Pembrokeshire.
Congratulations to Dr Ifan Rees who won 2nd prize in the Ed Major prize competition for his excellent presentation of his study on the effectiveness of the checklist in reducing errors.
We should be humble enough to realise that we are human and will not get it perfectly right every time. The checklist is just a tool to assist us. It's free. It's harmless. It works.
Quote of the day: We need to get away from the idea that "I don't need to use a checklist because I'm a good doctor" to "I'm a good doctor therefore I will use a checklist"
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