Anesthesiology Commons^™

Ventilation Method During Intensive Care Unit Transport After Cardiac Surgeries; When Should We Use A Ventilator?, Francis Anderson, Do, Kent Berg, Md, Marc Torjman, Phd, Yoshihisa Morita, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement: Manual ventilation with AMBU bag is utilized mostly for transporting post cardiac surgery patients to the intensive care unit, but some patients need mechanical ventilation due to concern for oxygenation, ventilation, and cardiac function.

Also, transport can be a critical moment because of limited hemodynamic information and suboptimal environment for therapeutic intervention.

Thus, risk stratification for appropriate ventilation is necessary for safe transport. •

Project AIM: We assessed biventricular function (with a hand-held echocardiography), arterial blood gas, and hemodynamics pre and post transport in manual and mechanical ventilation groups.

Medication Safety In The Operating Room, Tzvi Grossman, Michael Glick, Alexandra Mulholland, Febina Padiyath, Fred Balzer

Health Equity and Quality Improvement (HEQI) Summit

The operating room is an area where a significant number of adverse drug events occur. Anesthesia providers administer potentially dangerous medications with very little oversight. We looked for a way to decrease the likelihood that a lethal dose of phenylephrine (10mg) would be given to a patient.

Development Of Interdisciplinary Communication Tools To Improve Handoffs For Emergent Airway Management, Aaron Ocker, Do, Daniel Katz, Do, Jason Kopenitz, Do, Daniel Casey, Alexander Olson, Anna Rabinowitz, Md

Health Equity and Quality Improvement (HEQI) Summit

Project goal

Improve response time from airway alert to intubation while ensuring pertinent critical patient information is communicated to the airway team to reduce negative patient outcomes and better mobilize anesthesia resources.

Creation Of A Dedicated Anesthesia Airway Cart For Use In High-Volume Covid-19 Airway Management, Anna Rabinowitz, Alexander M. Olson, Daniel Casey, Elaine Kilmartin

Health Equity and Quality Improvement (HEQI) Summit

The COVID-19-specific approach to intubation required a change in the team structure and workflow for emergent airway management.

1. New need for bulky PPE and the introduction of an aerosol barrier shield for emergent intubations
2. Higher volume of intubations and use of videolaryngoscopy requires additional equipment
3. Concern for Code Cart contamination and wastage of airway equipment
4. Desire for more efficient approach to selecting and customizing equipment

Initiatives In Anesthesia Workspace Hygiene During Covid-19: The Gray Airway Basin And The Epic Hand Hygiene Event, Anna Rabinowitz, Kent Berg, Daniel Casey, Dietrich Gravenstein

Health Equity and Quality Improvement (HEQI) Summit

What’s the Problem?

The COVID-19 Pandemic has highlighted the need for anesthesia providers to decrease workspace contamination, particularly during and after airway management.

Delineation of “clean” and “dirty” spaces in the anesthesia workplace has been historically challenging, but the heightened awareness of microbial contamination presents a new opportunity to effect behavioral change among staff.

Anesthesiologist-Led Covid-19 Airway Training Skills Session To Teach Novel Team Approach And Workflow, Anna Rabinowitz, Daniel Casey, Elaine Kilmartin

Health Equity and Quality Improvement (HEQI) Summit

What’s the Problem?

Intubation is an aerosol-generating procedure that poses a significant infectious risk to the operator in the COVID-19 era, where the volume of intubations was expected to increase dramatically. Following national anesthesia societal and organizational recommendations regarding best practices to decrease risk of viral transmission, a new 3-person airway team approach was developed. Additions to the preexisting airway management workflow included an aerosol-containing intubation shield, a new breathing circuit configuration incorporating HEPA filtration, and the use of unfamiliar PPE, all of which required mastery of a complex sequence of events surrounding the patient encounter. This high-stakes workflow was …

Development And Implementation Of A Covid-19 Specific Peri-Operative Workflow For Anesthesia Providers, Alexander Olson, David Maguire, David Gratch, Dietrich Gravenstein, Michael Mahla, Anna Rabinowitz

Health Equity and Quality Improvement (HEQI) Summit

What's the Problem?

• Needed to develop and clarify the use of PPE in the COVID-19 era
• New considerations for infection control in OR
• Unique airway equipment and filter placement considerations
• Potential shortages of equipment and medications, need for conservation
• Need to incorporate human factors principles into protocol release and procedural compliance

We realized that there was no standard protocol for these functions existing in a visually compelling graphic form for wide distribution throughout anesthesia care areas, and sought to create one.