Intubation Success Rates and Complications After Implementation of a Pre-intubation Checklist

Abstract

<h3>Introduction</h3> RSI is fundamental in caring for critical patients, especially for HEMS crews. Multiple variables make RSI a high-risk procedure. Checklists have become ubiquitous to protocolize tasks and minimize adverse events. A pre-intubation checklist was implemented to standardize RSI for our HESM crews. <h3>Methods</h3> A retrospective chart review was completed for the 18 months prior to and after implementation of a pre-intubation checklist. Patient charts were analyzed for pre-intubation checklist utilization and complications such as bradycardia, hypoxia, cardiac arrest, and esophageal intubation. <h3>Results</h3> The checklist was used 46.8% of times after implementation. First-pass intubation did not improve and there was no decrease in peri-intubation complications before or after checklist implementation. Following initiation and when utilized, though, more peri-intubation complications were documented.Unlabelled image <h3>Conclusion</h3> The pre-intubation checklist was not routinely used, did not lead to improvement in first-pass success, and did not improve peri-intubation complications.