Biramahire Joseph, Pereira Matthew, Manirafasha Appolinaire, Uwamahoro Doris Lorette, Mvukiyehe Jean Paul, Banguti Paulin, Tuyishime Eugene
Department of Emergency Medicine, Kibagabaga Hospital, Rwanda.
Schulich School of Medicine and Dentistry, Western University, ON, Canada.
Afr J Emerg Med. 2025 Sep;15(3):100871. doi: 10.1016/j.afjem.2025.03.002. Epub 2025 Jun 11.
Airway management is a critical aspect of emergency care, and adherence to standardized protocols can improve patient outcomes. However, in resource-limited settings such as Rwanda, the implementation of airway management protocols in the emergency department (ED) may face challenges. This study aims to evaluate the impact of implementing the Safe Airway Checklist (SAC) on airway management practices and post-intubation complications in a major teaching hospital in Rwanda.
A pre- and post-intervention study design was used to assess the impact of the SAC on intubation practices and post-intubation checklist in the ED at the University Teaching Hospital of Kigali. The study included a baseline assessment of residents' intubation practices, followed by implementation of the SAC, and post-implementation data collection to evaluate changes in adherence to airway management practices and post-intubation complications.
Among 77 intubation (40 pre-intervention and 37 post-intervention), the implementation of the SAC led to improvement in 4 key airway management practices (airway cart and glidescope setup, premedication use, restraining patients, and checking ABG within 10-15 min) in the ED. However, the reduction in rates of post-intubation complications was not statistically significant.
The implementation of the Safe Airway Checklist in the ED of a major teaching hospital in Rwanda significantly improved several critical aspects of airway management. While no statistically significant reduction in post-intubation complications were observed, the decreasing trend of complication rates suggests promising benefits that merit further exploration. These findings highlight the value of standardized checklists in enhancing clinical practices and underscore the need for ongoing research to fully understand their impact on patient outcomes especially in low resources settings.
气道管理是急诊护理的关键环节，遵循标准化方案可改善患者预后。然而，在卢旺达等资源有限的环境中，急诊科实施气道管理方案可能面临挑战。本研究旨在评估在卢旺达一家大型教学医院实施安全气道检查表（SAC）对气道管理实践和插管后并发症的影响。
采用干预前后研究设计，评估SAC对基加利大学教学医院急诊科插管实践和插管后检查表的影响。该研究包括对住院医师插管实践的基线评估，随后实施SAC，并在实施后收集数据，以评估气道管理实践依从性和插管后并发症的变化。
在77例插管病例中（干预前40例，干预后37例），SAC的实施使急诊科4项关键气道管理实践（气道推车和可视喉镜设置、使用术前用药、约束患者以及在10 - 15分钟内检查动脉血气）得到改善。然而，插管后并发症发生率的降低无统计学意义。
在卢旺达一家大型教学医院的急诊科实施安全气道检查表显著改善了气道管理的几个关键方面。虽然未观察到插管后并发症发生率有统计学意义的降低，但并发症发生率的下降趋势表明可能存在有益效果，值得进一步探索。这些发现凸显了标准化检查表在加强临床实践中的价值，并强调需要持续开展研究，以充分了解其对患者预后的影响，尤其是在资源匮乏的环境中。
