Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
Department of Pediatrics - Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Emerg Med J. 2023 Apr;40(4):287-292. doi: 10.1136/emermed-2022-212758. Epub 2023 Feb 14.
Airway management checklists have improved paediatric patient safety in some clinical settings, but consensus on the appropriate components to include on a checklist for paediatric tracheal intubation in the ED is lacking.
A multidisciplinary panel of 14 experts in airway management within and outside of paediatric emergency medicine participated in a modified Delphi approach to develop consensus on the appropriate components for a paediatric airway management checklist for the ED. Panel members reviewed, modified and added to the components from the National Emergency Airway Registry for Children airway safety checklist for paediatric intensive care units using a 9-point appropriateness scale. Components with a median score of 7.0-9.0 and a 25th percentile score ≥7.0 achieved consensus for inclusion. A priori, the modified Delphi method was limited to a maximum of two rounds for consensus on essential components and one additional round for checklist creation.
All experts participated in both rounds. Consensus was achieved on 22 components. Twelve were original candidate items and 10 were newly suggested or modified items. Consensus components included the following categories: patient assessment and plan (5 items), patient preparation (5 items), pharmacy (2 items), equipment (7 items) and personnel (3 items). The components were formatted into a 17-item clinically usable checklist.
Using the modified Delphi method, consensus was established among airway management experts around essential components for an airway management checklist intended for paediatric tracheal intubation in the ED.
气道管理检查表在某些临床环境中提高了儿科患者的安全性，但在 ED 中儿科气管插管的检查表应包含哪些适当的内容方面尚未达成共识。
由 14 名在儿科急诊医学内外气道管理方面的多学科专家组成的小组，采用改良 Delphi 方法就 ED 儿科气道管理检查表的适当内容达成共识。小组成员使用 9 分适宜性量表审查、修改和添加来自国家儿童急症气道登记处儿科重症监护病房气道安全检查表中的内容。中位数评分为 7.0-9.0，25%分位数评分≥7.0 的组件达成纳入共识。事先规定，改良 Delphi 方法最多只能进行两轮以达成基本组件的共识，然后再进行一轮清单创建。
所有专家都参加了两轮。达成了 22 个组件的共识。其中 12 个是原始候选项目，10 个是新建议或修改的项目。达成共识的组件包括以下几类：患者评估和计划（5 项）、患者准备（5 项）、药房（2 项）、设备（7 项）和人员（3 项）。这些组件被格式化为一个 17 项的临床可用清单。
使用改良 Delphi 方法，气道管理专家就 ED 中儿科气管插管的气道管理检查表的基本内容达成了共识。
