Intubation quality assurance thresholds.
BACKGROUND
Quality assurance (QA) and continuous quality improvement (CQI) are valued activities within health-care organizations. Quality assurance indicators as guidelines for quality practice usually are established intuitively. The purpose of this study was to determine an appropriate threshold for successful intubation in patients transported by air and to examine factors impacting this success rate.


METHODS
Fifteen rotor-wing programs from across the United States participated.


METHODS
The study was a prospective descriptive design. A total of 369 flight crew members agreed to participate, and intubations were attempted on 862 patients during the 12-month study.


RESULTS
Intubations were attempted on 862 patients and were successful in 788 (91.4%) of the patients. Of the patients not successfully intubated, 14 received supplemental oxygen only, 25 were supported with bag-valve-mask, 26 received a surgical cricothyroidotomy and for nine patients it was unknown what form of airway support was provided.


CONCLUSIONS
Factors impacting successful intubation include cardiac arrest, use of neuromuscular blockade, use of sedatives and facial trauma. Data from the study support a threshold for successful intubation of between 90% and 95%.
University of Utah College of Nursing, Salt Lake City, USA.
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Thompson
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Balasz
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Goltermann
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Eastes
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Ignacio
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A
Koestner
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Pearson
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Krasneski-Schreiber
D017732:Air Ambulances / Q000592:standards*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007442:Intubation, Intratracheal / Q000592:standards*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D014187:Transportation of Patients; D014481:United States