• Br J Anaesth · Feb 2022

    Establishing quality indicators for prehospital advanced airway management: a modified nominal group technique consensus process.

    • Alexandre Kottmann, Andreas J Krüger, Geir A Sunde, Jo Røislien, John-Kenneth Heltne, Pierre-Nicolas Carron, David Lockey, and SollidStephen J MSJMNorwegian Air Ambulance Foundation, Research and Development Department, Oslo, Norway; University of Stavanger, Faculty of Health Sciences, Department of Quality and Health Technology, Stavanger, Norway..
    • Norwegian Air Ambulance Foundation, Research and Development Department, Oslo, Norway; Lausanne University Hospital, Emergency Department, Lausanne, Switzerland; University of Stavanger, Faculty of Health Sciences, Department of Quality and Health Technology, Stavanger, Norway; Rega - Swiss Air Ambulance, Zürich, Switzerland. Electronic address: alex.kottmann@norskluftambulanse.no.
    • Br J Anaesth. 2022 Feb 1; 128 (2): e143-e150.

    BackgroundPre-hospital advanced airway management is a complex intervention composed of numerous steps, interactions, and variables that can be delivered to a high standard in the pre-hospital setting. Standard research methods have struggled to evaluate this complex intervention because of considerable heterogeneity in patients, providers, and techniques. In this study, we aimed to develop a set of quality indicators to evaluate pre-hospital advanced airway management.MethodsWe used a modified nominal group technique consensus process comprising three email rounds and a consensus meeting among a group of 16 international experts. The final set of quality indicators was assessed for usability according to the National Quality Forum Measure Evaluation Criteria.ResultsSeventy-seven possible quality indicators were identified through a narrative literature review with a further 49 proposed by panel experts. A final set of 17 final quality indicators composed of three structure-, nine process-, and five outcome-related indicators, was identified through the consensus process. The quality indicators cover all steps of pre-hospital advanced airway management from preoxygenation and use of rapid sequence induction to the ventilatory state of the patient at hospital delivery, prior intubation experience of provider, success rates and complications.ConclusionsWe identified a set of quality indicators for pre-hospital advanced airway management that represent a practical tool to measure, report, analyse, and monitor quality and performance of this complex intervention.Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

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