Faculty Collaboration Database

Pediatric Tracheostomy Emergency Readiness Assessment Tool: International Consensus Recommendations. Laryngoscope 2023 Dec;133(12):3588-3601

Date

04/28/2023

Pubmed ID

37114735

Pubmed Central ID

PMC10710770

DOI

10.1002/lary.30674

Scopus ID

2-s2.0-85158009579 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

OBJECTIVE: To achieve consensus on critical steps and create an assessment tool for actual and simulated pediatric tracheostomy emergencies that incorporates human and systems factors along with tracheostomy-specific steps.

METHODS: A modified Delphi method was used. Using REDCap software, an instrument comprising 29 potential items was circulated to 171 tracheostomy and simulation experts. Consensus criteria were determined a priori with a goal of consolidating and ordering 15 to 25 final items. In the first round, items were rated as "keep" or "remove". In the second and third rounds, experts were asked to rate the importance of each item on a 9-point Likert scale. Items were refined in subsequent iterations based on analysis of results and respondents' comments.

RESULTS: The response rates were 125/171 (73.1%) for the first round, 111/125 (88.8%) for the second round, and 109/125 (87.2%) for the third round. 133 comments were incorporated. Consensus (>60% participants scoring ≥8, or mean score >7.5) was reached on 22 items distributed across three domains. There were 12, 4, and 6 items in the domains of tracheostomy-specific steps, team and personnel factors, and equipment respectively.

CONCLUSIONS: The resultant assessment tool can be used to assess both tracheostomy-specific steps as well as systems factors affecting hospital team response to simulated and clinical pediatric tracheostomy emergencies. The tool can also be used to guide debriefing discussions of both simulated and clinical emergencies, and to spur quality improvement initiatives.

LEVEL OF EVIDENCE: 5 Laryngoscope, 133:3588-3601, 2023.

Author List

Schiff E, Propst EJ, Balakrishnan K, Johnson K, Lounsbury DW, Brenner MJ, Tawfik MM, Pediatric Tracheostomy Emergency Readiness Workgroup, Yang CJ

Authors

Robert H. Chun MD Professor in the Otolaryngology department at Medical College of Wisconsin
Michael E. McCormick MD Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Computer Simulation
Consensus
Delphi Technique
Emergencies
Humans
Tracheostomy