just back from SMACCGOLD. Fun and energising event of the year for me!
You might have heard Tim Leeuwenberg and I had a debate regarding checklists and airway experts
I must say he debated very well and was the clear audience favourite. When Cliff Reid polled the expert panel on their opinion, here were the results.
Did they use airway checklists?
Dr Richard Levitan = NO
Dr Keith Greenland = NO
Dr Scott Weingart = YES
Interpret as you may but in my mind the fact that recognised airway experts can disagree on the benefit/safety of checklists for airway management means that experts do not need to use them. Certainly they may choose to use them but that was not the debate topic.
Anyway I was surprised since the debate that an Article in Press in the American Journal of EM came out on perintubation checklists!
Here it is
Key points about the study:
– retrospective, before and after analysis
-underpowered to show outcome differences
– RSI rates significantly more post checklist
– no significant difference in intubation attempts nor success
-no significant difference in haemdynamics nor oxygen desaturation rates with use of checklist
– Mix of anaesthesia and EM docs prior to CL , then 99% EM docs doing intubations post CL so potential confounder
So at least understand the latest evidence and make up your own mind. I am trying to develop and implement a RSI checklist in my aeromedical base and its not as simple as you might think. To my mind the most important thing is training and review. If a CL helps you do that, great. If not, dont get fixated on it. Certainly the evidence is not that clear cut!