Population  of  interest

  1. All patients who received ETT/cricothyroidotomy/supraglottic airway/NPA
  2. All patients with compromised airway (initial GCS < 8 or abbreviated injury scale (AIS) head and neck ≥ 3, or AIS face ≥ 3).

Intent  (Expected  Outcomes)

  1. All injured patients who present with obtundation (GCS<8), apnea, respiratory distress or insufficiency, airway obstruction, or impending airway loss will have a secure and definitive airway established expeditiously upon arrival to a Role 2 or Role 3 if not done prehospital.
  2. SpO2 is maintained between≥ 90% and 96%. SpO2 >96% is not necessary.13
  3. Patients with a definitive airway (endotracheal tube, cricothyroidotomy, tracheostomy) have ETCO2 monitoring to confirm airway placement.

Performance/Adherence  Metrics

  1. Number and percentage of patients in the population of interest who had a secure and definitive airway (endotracheal tube, cricothyroidotomy, tracheostomy) established or verified, or documentation of appropriate intervention.
  2. Number and percentage of patients in the population of interest with SpO2 < 90%<80%, <70%, <60%.
  3. Number and percentage of patients who had definitive airway (endotracheal tube, cricothyroidotomy, tracheostomy) with ETCO2 documented at the same role of care where the procedure is done.

DATA  SOURCES

  • Patient Record
  • Department of Defense Trauma Registry (DoDTR)

System  Reporting  &  Frequency

The above constitutes the minimum criteria for PI monitoring of this CPG. System reporting will be performed annually; additional PI monitoring and system reporting may be performed as needed.

The system review and data analysis will be performed by the JTS Chief and the JTS PI Branch.

Responsibilities

It is the trauma team leader’s responsibility to ensure familiarity, appropriate compliance and PI monitoring at the local level with this CPG.