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Table 3 Final airway management variables

From: Standardised data reporting from pre-hospital advanced airway management – a nominal group technique update of the Utstein-style airway template

FINAL AIRWAY MANAGEMENT VARIABLES (data provided by provider performing the intervention)
Number Data variable name Type of data Data variable categories or values
Choose only one option unless otherwise stated.
Definition of data variable
19 Use of checklist for airway management Ordinal 1 = Written checklist available and used on scene
2 = Written checklist available, but not used
3 = No checklist available
Written checklist for airway management including rapid sequence induction (RSI) available in service and used on-scene (challenge and response system).
20 Oxygenation strategy for airway management Ordinal 1 = Preoxygenation with non rebreathable face mask before airway attempt
2 = Preoxygenation with Bag-valve-mask (BVM) before airway attempt
3 = Apnoeic oxygenation during airway attempt
4 = No preoxygenation
Oxygenation strategies used before or during advanced airway management.
Select all that apply.
21 Sequence of providers performing airway management Nominal ☐☐ Emergency Medical Technician
☐☐ Paramedic
☐☐ Nurse (non-anaesthesia)
☐☐ Nurse (anaesthesia)
☐☐ Physician (General practitioner or other non-EP/ICU/Anaesthesiologist)
☐☐ Physician (Emergency Physician - EP)
☐☐ Physician (Intensivist - ICU)
☐☐ Physician (Anaesthesiologist)
☐☐ Unknown
Specify level of EMS provider in sequence, who performed each airway management attempt, numbered in order of attempt.
Select all that apply.
Specify number of attempt alongside corresponding provider with “1” and if more attempts “2”, “3”,“4”.
E.g.: If paramedic fails first attempt, then physician has two attempts, this is recorded as:
“1” Paramedic.
“2–3” Physician.
Select all that apply.
22 Sequence of airway devices used for airway management Nominal ☐☐ Bag-valve-mask ventilation (BVM)
☐☐ Supraglottic airway device with suction
☐☐ Supraglottic airway device without suction
☐☐ Direct laryngoscopy with endotracheal tube
☐☐ Direct laryngoscopy with endotracheal tube and stylet
☐☐ Direct laryngoscopy with bougie and endotracheal tube
☐☐ Video laryngoscopy (Macintosh or Miller like blade) with endotracheal tube
☐☐ Video laryngoscopy (Macintosh or Miller like blade) with endotracheal tube and stylet
☐☐ Video laryngoscopy (Macintosh or Miller like blade) with bougie and endotracheal tube
☐☐ Video laryngoscopy (hyperangulated blade) with endotracheal tube
☐☐ Video laryngoscopy (hyperangulated blade) with endotracheal tube and stylet
☐☐ Video laryngoscopy (hyperangulated blade) with bougie and endotracheal tube
☐☐ Surgical emergency airway equipment
☐☐ Percutaneous emergency airway equipment
☐☐ Jet-ventilation equipment
☐☐ Other, describe: _______________
☐☐ Unknown
Specify first attempt with “1” and if more attempts “2”, “3”,“4”.
E.g.: If first attempt fails with endotracheal intubation and direct laryngoscopy, and the next two attempts are endotracheal intubation with video laryngoscopy, this is recorded as:
“1” Direct laryngoscopy with endotracheal tube
“2–3” Video laryngoscopy (Macintosh or Miller like blade) with endotracheal tube
BVM = Bag-valve-mask ventilation, includes insertion of oro/nasopharyngeal airway.
If bag-valve-mask ventilation prior to RSI, choose “BVM” as “1”.
Video laryngoscopy (VL) differentiates between:
VL with Macintosh/miller like blade
VL with hyperangulated blade
Select all that apply.
23 Airway management results Ordinal 1 = Successful airway management with ET as planned
2 = Successful airway management with SAD as planned
3 = Successful airway management with surgical airway as planned
4 = Failure of primary airway plan, and airways secured by alternative technique
5 = Final airway management failed (loss of airways)
6 = Unknown
ET = Endotracheal tube
SAD = Supraglottic airway device
24 Airway manoeuvres following failed airway attempt. Nominal 1 = Cricoid pressure released
2 = BURP/ELM manoeuvres
3 = Release MILS
4 = Reposition patient
5 = Ramping patient
6 = None / Not applicable.
Airway manoeuvres following unsuccessful airway management attempts.
BURP = Backwards upwards rightwards pressure.
ELM = External laryngeal manipulation
MILS = Manual In-line stabilisation
Ramping = The head and trunk are elevated or supported to align the external auditory meatus with the sternal notch in the horizontal plane
Select all that apply.
25 Drugs used to facilitate airway management Nominal 1 = None
2 = Thiopental
3 = Ketamine
4 = S-ketamine
5 = Propofol
6 = Fentanyl
7 = Alfentanil
8 = Morphine
9 = Midazolam
10 = Diazepam
11 = Suxamethonium
12 = Rocuronium
13 = Vasopressor
14 = Lidocain
15 = Etomidate
16 = Other, describe: ________________
Drugs used to facilitate the actual airway intervention, not including sedation in the post-intervention or transport phase.
Vasopressor includes any drug used as vasopressor during airway management, e.g. phenylephrine.
Local anaesthetic includes any drug used as local or regional anaesthetic, e.g. lidocaine.
Select all that apply.
26 Complications during airway management Nominal 1 = ET misplaced in oesophagus AND recognised/corrected immediately
2 = ET misplaced in oesophagus and NOT recognised/corrected immediately
3 = ET misplaced in left or right main stem bronchus
4 = Incorrect positioning or difficult ventilation with SAD
5 = Dental trauma
6 = Aspiration or vomiting during airway management (and NOT present before)
7 = Cardiac arrest during airway management
8 = Hypoxia during airway management
9 = Bradycardia during airway management
10 = Hypotension during airway management
11 = Complications during surgical or percutaneous airway (e.g. bleeding or pneumothorax)
12 = No complications (confirmed) during airway management
13 = Insufficient data recording, complications unsure.
Complications recognised during airway management or device verification (and NOT present before the airway management).
Select all that apply.
ET = Endotracheal tube, SAD = Supraglottic airway device
The following definitions are used:Hypoxia: Adults and children: SpO2 < 90%
Hypotension:
infants < 1 year: SBP < 70 mmHg
children 1 to 10 years: SBP < 70 + (2 × age)
children > 10 years: SBP < 90 mmHg
adults: SBP < 90 mmHg or decrease > 10% from baseline value
Bradycardia
newborn to 3 years: <  100 bpm
3 to 9 years: <  80 bpm
10 to 16 years: <  60 bpm
adults: <  50 bpm
Select all that apply.
27 Total number of successful endotracheal intubations the provider has performed in patients Ordinal 0 = < 10
1 = 11–25
2 = 26–50
3 = 51–100
4 = 101–250
5 = 251–1000
6 = 1001–2500
7 = > 2500
Total number of successful endotracheal intubations the provider has performed in patients in hospital and pre-hospital service, not including mannequin intubations or SAD.
28 Blood pressure, after finalised airway management Continuous and Nominal 1 = Number, describe (Syst-BP/Dias-BP (MAP))
2 = NA: Did not measure
3 = NA: Could not measure
Value recorded within 1–3 min after finalised airway management
29 SpO2, after finalised airway management Continuous and Nominal 1 = Number, describe
2 = NA: Did not measure
3 = NA: Could not measure
Value recorded within 1–3 min after finalised airway management
30 EtCO2, after finalised airway management Continuous and Nominal 1 = Number, describe
2 = NA: Did not measure
3 = NA: Could not measure
Value recorded within 1–3 min after finalised airway management
31 Ventilation, after finalised airway management Nominal 1 = Spontaneous ventilation
2 = Controlled manual ventilation
3 = Controlled mechanical ventilation (ventilator)
4 = Mixed ventilation
5 = Unknown
Main mode of ventilation on-scene and during transport of patient following finalised airway management.
If both spontaneous and controlled ventilation, choose “mixed ventilation”
32 Survival to hospital Nominal 1 = Dead on-scene after ALS interventions
2 = Alive on hospital arrival (including patients being transported with on-going mechanical chest compressions or ECPR)
3 = Unknown
Patient survival status limited to pre-hospital treatment and arrival at hospital (Short term survival)
ALS = Advanced Life Support
ECPR = extracorporeal cardiopulmonary resuscitation