Emergency Department Intubation Checklist v13

July 8th, 2012
by reuben in airway

vector image for screen viewing

acrobat document for printing

Changes in v13:

  • nasal cannula and preoxygenation sections beefed up
  • added airway management strategy section
  • removed incremental FiO2/PEEP chart
  • roc dose changed from TBW to IBW
  • added section on cricothyrotomy technique
  • ultrasound added to post-intubation complications assessment
  • added proviso, “pretreatment agents are always optional.”
  • added S to DOPES mnemonic (breath stacking)
  • added “function” to “verify cuff” for ETT
  • changed phenylephrine from post to peri intubation hypotension
  • fancy style enhancements

Bonus: personnel arrangement diagram

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Responses to “Emergency Department Intubation Checklist v13”

  1. Hi Reuben

    I’m interested to know how the checklist is actually used. That is, are doctors & nurses ticking boxes as they call out the list, or is it used more as an aid memoir. I’ve produced a set of guidelines for my ED but in reality they arnt referred to, which is frustrating!

    Thanks
    Adam

    apherbie at
  2. The checklist is designed to be one page, front and back, a stack of them sitting in a strategic area (e.g. attached to the airway cart). When you (the operator) decide a patient requires ETI, grab a checklist and march down the page. If you supervise trainees, hand it to your senior trainee and ask her to get you when she’s ready to go, or go over it together with your junior trainee. The goal is to reduce errors and omissions; airway management entails a zillion small things that if forgotten can be a big problem. The checklist lightens your cognitive load so you can focus on the big picture.

  3. Thanks! I appreciate the blog, all great stuff.
    Adam

    apherbie at
  4. Another question…!

    To provide some leverage to persuade my ED to utilise in this way, do you know of data supporting use of such a checklist in an ED?

    Thanks
    Adam

    apherbie at
  5. there are many peripherally related studies; here are a few pubmed IDs to start:

    21908802
    21500001
    21069898
    19088623
    15976240

  6. reub- I like the new version! one suggestion I have re: NC oxygenation. I’ve tried wearing an NC at 15lpm and while it’s a little tickly it’s certainly tolerable. if the patient can take it, I like turning it up to 15 at the onset and leaving it there, rather than making it one more thing to remember during the time-sensitive part of RSI

  7. good point and I agree. will change in v14. thanks.