Martin Nichols1
1NSW Ambulance, NSW, Australia
Biography:
To be provided if approved by NSWA
Abstract:
Effective airway management plays a crucial role in emergency medical care. Regularly reviewing and analysing advanced airway interventions is essential for quality improvement. In 2020, New South Wales Ambulance (NSWA) established an airway registry to monitor service-wide airway proficiency and identify opportunities for enhancement. Initially, the registry was exclusively completed by Intensive Care Paramedics (ICPs).
The initial analysis of the registry after one year of operation revealed a significant increase in overall and first-pass intubation success when using video laryngoscopes compared to direct laryngoscopy. Consequently, NSW Ambulance increased its investment in video laryngoscopes.1
Over the subsequent two years, the airway registry usage by ICPs demonstrated substantial improvements in advanced airway first• pass success rates. Additionally, the registry highlighted that NSWA clinicians frequently encounter contaminated airways (22%).2
In response, a large board rigid suction device was introduced to aid in airway contamination clearance.
Since September 2022, the registry has been accessible to all clinicians inserting advanced airways, allowing them to record details of all attempts at airway management. The past 18 months have provided valuable insights into the airways managed by paramedics and ICPs. At the 2024 Council of Ambulance Authorities (CAA) Congress, NSWA will share further lessons learned from the expanded use of this airway registry.
1 Nichols M, Fouche PF, Bendall JC. Video versus direct laryngoscopy by specialist paramedics in New South Wales: preliminary results from a new airway registry. Emerg Med Australas 2022; 34: 984-988.
2 Nichols M, Fouche PF, McPherson, T, Evens, T, Bendall JC. Lessons from the first two years of a new out-of-hospital airway registry in New South Wales. Paramedicine 2023; 20(5): 152-160.