O005 / #486: INTUBATION PRACTICES FOR CHILDREN IN EMERGENCY DEPARTMENTS AND INTENSIVE CARE UNITS ACROSS AUSTRALIA AND NEW ZEALAND: A SURVEY OF MEDICAL STAFF

Abstract

Aims & Objectives: Intubation of children in the emergency setting is a high risk, low incidence event. Standardisation of clinical practice has been hampered by a lack of high-quality evidence to support one technique over another. We aim to report clinician preference in intubation practice of children in emergency departments (EDs) and intensive care units (ICUs) in Australia and New Zealand as baseline information to allow targeted research focused on improving the safety of paediatric emergency airway management. Methods: A voluntary questionnaire was undertaken by medical staff in EDs and ICUs associated with the Paediatric Research in Emergency Departments International Collaborative (PREDICT) and Australia and New Zealand Intensive Care Society Paediatric Study Group (ANZICS PSG) research networks. Respondents reported on their individual intubation practices. Results: A total of 502 clinicians were invited to complete the survey between May and October 2018 with 336 (66.9%) responding. There was marked variation in practice between ED clinicians and ICU clinicians in the in the techniques used for pre-oxygenation, the frequency of use of apnoeic oxygenation, and the reported use of video laryngoscopy.Conclusions: This survey highlights the self-reported variations in clinical practice in the intubation of children in the emergency and intensive care settings in Australia and New Zealand. While there is unlikely to be a one-size-fits-all approach to paediatric airway management, there is a paucity of high-quality evidence to support clinicians in adopting a best practice approach. Targeted research into preoxygenation techniques, the role and method of apnoeic oxygenation, and the role of VL in paediatric intubation is warranted.