Dataset Information

Standard operating procedure changed pre-hospital critical care anaesthesiologists' behaviour: a quality control study.

ABSTRACT: INTRODUCTION: The ability of standard operating procedures to improve pre-hospital critical care by changing pre-hospital physician behaviour is uncertain. We report data from a prospective quality control study of the effect on pre-hospital critical care anaesthesiologists' behaviour of implementing a standard operating procedure for pre-hospital controlled ventilation. MATERIALS AND METHODS: Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region prospectively registered pre-hospital advanced airway-management data according to the Utstein-style template. We collected pre-intervention data from February 1st 2011 to January 31st 2012, implemented the standard operating procedure on February 1st 2012 and collected post intervention data from February 1st 2012 until October 31st 2012. We included transported patients of all ages in need of controlled ventilation treated with pre-hospital endotracheal intubation or the insertion of a supraglottic airways device. The objective was to evaluate whether the development and implementation of a standard operating procedure for controlled ventilation during transport could change pre-hospital critical care anaesthesiologists' behaviour and thereby increase the use of automated ventilators in these patients. RESULTS: The implementation of a standard operating procedure increased the overall prevalence of automated ventilator use in transported patients in need of controlled ventilation from 0.40 (0.34-0.47) to 0.74 (0.69-0.80) with a prevalence ratio of 1.85 (1.57-2.19) (p?=?0.00). The prevalence of automated ventilator use in transported traumatic brain injury patients in need of controlled ventilation increased from 0.44 (0.26-0.62) to 0.85 (0.62-0.97) with a prevalence ratio of 1.94 (1.26-3.0) (p?=?0.0039). The prevalence of automated ventilator use in patients transported after return of spontaneous circulation following pre-hospital cardiac arrest increased from 0.39 (0.26-0.48) to 0.69 (0.58-0.78) with a prevalence ratio of 1.79 (1.36-2.35) (p?=?0.00). CONCLUSION: We have shown that the implementation of a standard operating procedure for pre-hospital controlled ventilation can significantly change pre-hospital critical care anaesthesiologists' behaviour.

SUBMITTER: Rognas L

PROVIDER: S-EPMC4029444 | biostudies-other | 2013

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Standard operating procedure changed pre-hospital critical care anaesthesiologists' behaviour: a quality control study.

Rognås Leif L Hansen Troels Martin TM Kirkegaard Hans H Tønnesen Else E

Scandinavian journal of trauma, resuscitation and emergency medicine 20131205

<h4>Introduction</h4>The ability of standard operating procedures to improve pre-hospital critical care by changing pre-hospital physician behaviour is uncertain. We report data from a prospective quality control study of the effect on pre-hospital critical care anaesthesiologists' behaviour of implementing a standard operating procedure for pre-hospital controlled ventilation.<h4>Materials and methods</h4>Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Regi ...[more]

PMID: 24308781

Similar Datasets

Project description:IntroductionWe report prospectively recorded observational data from consecutive cases in which the attending pre-hospital critical care anaesthesiologist considered performing pre-hospital advanced airway management but decided to withhold such interventions.Materials and methodsAnaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region (a mixed rural and urban region with 1.27 million inhabitants) registered data from February 1st 2011 to October 31st 2012. Included were patients of all ages for whom pre-hospital advanced airway management were considered but not performed. The main objectives were to investigate (1) the pre-hospital critical care anaesthesiologists' reasons for considering performing pre-hospital advanced airway management in this group of patients (2) the pre-hospital critical care anaesthesiologists' reasons for not performing pre-hospital advanced airway management (3) the methods used to treat these patients (4) the incidence of complications related to pre-hospital advanced airway management not being performed.ResultsWe registered data from 1081 cases in which the pre-hospital critical care anaesthesiologists' considered performing pre-hospital advanced airway management. The anaesthesiologists decided to withhold pre-hospital advanced airway management in 32.1% of these cases (n =?347). In 75.1% of these cases (n =?257) pre-hospital advanced airway management were withheld because of the patient's condition and in 30.8% (n =?107) because of patient co-morbidity. The most frequently used alternative treatment was bag-mask ventilation, used in 82.7% of the cases (n =?287). Immediate complications related to the decision of not performing pre-hospital advanced airway management occurred in 0.6% of the cases (n =?2).ConclusionWe have illustrated the complexity of the critical decision-making associated with pre-hospital advanced airway management. This study is the first to identify the most common reasons why pre-hospital critical care anaesthesiologists sometimes choose to abstain from pre-hospital advanced airway management as well as the alternative treatment methods used.

Dataset Information

Standard operating procedure changed pre-hospital critical care anaesthesiologists' behaviour: a quality control study.

Publications

Standard operating procedure changed pre-hospital critical care anaesthesiologists' behaviour: a quality control study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets