Authors (including presenting author) :
Gan YT(1), Lo OTI(1), Wong KW(1), Fung SS(1), Wan HYS(1), Wong LY(1)
Affiliation :
(1)Department of Cardiothoracic Surgery, Queen Mary Hospital
Introduction :
Videolaryngoscopy (VL) has become an important tool in airway management because it provides better glottic visualization and higher successful rate of intubation. Moreover, VL intubation has been recommended in intubating critically ill patients. In the hope of enhancing work efficacy and efficiency, and most importantly patient safety, a VL-integrated intubation trolley (VLIIT) has been introduced in Queen Mary Hospital Cardiothoracic Surgical Intensive Care Unit (QMH CTSICU) in November 2024.
Objectives :
To set up a customized VLIIT to facilitate VL intubation in QMH CTSICU.
To re-engineer the pre-intubation equipment preparation workflow in QMH CTSICU.
Methodology :
A two-layered intubation box was available previously. It contained the basic necessities for direct laryngoscopy (DL) intubation while VL equipment was stored in another cabinet. When VL was requested, VL equipment had to be prepared separately.
With the increasing trend of VL intubation, the novel six-drawer VLIIT has been introduced. In addition to the items in the intubation box, equipment required in VL intubation and pre-oxygenation have been supplemented. The VLIIT layout is tailored according to the intubation procedure. The C-MAC imager and monitor has become readily available on the VLIIT. VL and DL blades are stored in the first two drawers. Equipment for basic airway management and pre-oxygenation, such as oropharyngeal airways and Laerdal resuscitator are placed on the two sides of the trolley and the third drawer. Endotracheal tubes and related equipment are positioned in the fourth drawer. Since a feeding tube is routinely inserted by the anaesthetist immediately after successful intubation, equipment for feeding tube insertion is incorporated in the fifth drawer. Some supplementary suctioning devices are placed in the last drawer.
Before commencing usage of the VLIIT, an educational video on the operation of VL and briefing of the layout of VLIIT were provided to all CTSICU nurses to ensure safe use and familiarization with the trolley.
Result & Outcome :
The VLIIT has been used in three intubation scenarios. Brief feedback on the VLIIT has been collected. In the future, surveys will be conducted via interview to evaluate the efficacy of the intubation trolley on improving the workflow of intubation in QMH CTSICU. Moreover, ongoing modification will be made according to users’ comments.
