The Experts below are selected from a list of 37812 Experts worldwide ranked by ideXlab platform

Alexander T Hillel - One of the best experts on this subject based on the ideXlab platform.

  • difficult Airway Response team a novel quality improvement program for managing hospital wide Airway emergencies
    Anesthesia & Analgesia, 2015
    Co-Authors: Lynette Mark, Renee Cover, Kurt R Herzer, Vinciya Pandian, Nasir I Bhatti, Lauren C Berkow, Elliott R Haut, Alexander T Hillel, Christina Miller, David J Fellerkopman
    Abstract:

    BACKGROUND:Difficult Airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency Airway management outside the operating room is particularly challenging.METHODS:We developed a quality improvement program—the Difficult Airway Response Team (

  • integration of a difficult Airway Response team into a hospital emergency Response system
    Anesthesiology Clinics, 2015
    Co-Authors: Monika Chmielewska, Vinciya Pandian, Bradford D Winters, Alexander T Hillel
    Abstract:

    : Hospital-wide emergency Response teams have been an area of development for several decades. Highly specialized to address emergent needs, they mimic the cardiac-pulmonary arrest teams established at hospitals nationwide, such as heart attack, brain attack, medical emergency, rapid Response, and difficult Airway Response teams (DART). The DART at Johns Hopkins Hospital is a collaboration of the Anesthesiology and Critical Care Medicine, Otolaryngology-Head and Neck Surgery, General Surgery, and Emergency Medicine departments. This successful model may be used by other hospitals to establish improved and comprehensive care of the difficult Airway patient.

  • a novel role for otolaryngologists in the multidisciplinary difficult Airway Response team
    Laryngoscope, 2015
    Co-Authors: Alexander T Hillel, Lynette Mark, Renee Cover, Vinciya Pandian, Lauren C Berkow, Elliott R Haut, Christina Miller, James H Clark, Yuri Agrawal, Nasir I Bhatti
    Abstract:

    Objectives/Hypothesis The Difficult Airway Response Team (DART) was implemented in July 2008 to address emergent difficult Airway situations. The main objective of this study was to highlight the unique role and skill set that otolaryngologists bring and their impact on patient outcomes. Study Design Retrospective review of prospectively collected data from the hospital's Airway registry. Methods We collected data on demographics, Airway characteristics, Airway management techniques used by each specialty, and clinical outcomes (such as cricothyrotomies) for patients for whom a code was activated between July 2006 and June 2010. We compared data between pre- and post-DART cohorts and between DART and non-DART patients using a matched case-control approach. Results Of the 2,826 codes, 90 patients required DART management between July 2008 and June 2010. Body mass index, cervical spine injury/fixation, history of difficult Airway, head and neck mass, and oropharyngeal and/or supraglottic angioedema were identified as significant predictors for DART activation. Forty-nine (60%) patients' Airways were secured by anesthesiologists, 30 (36%) by otolaryngologists, and three (4%) by trauma surgeons. Otolaryngologists were able to use specialized techniques such as Holinger and Dedo laryngoscopes to significantly decrease the number of cricothyrotomies from seven (0.73%) pre-DART implementation to four (0.21%) post-DART implementation. Conclusions Otolaryngologists were able to decrease the need for cricothyrotomies using specialized techniques for patients with difficult Airways. Otolaryngologists bring a special skill set to the DART that is beyond the scope of anesthesiologists and trauma surgeons and that can improve patient outcomes by preventing unnecessary emergency surgical Airways. Level of Evidence 2b Laryngoscope, 125:640–644, 2015

Lynette Mark - One of the best experts on this subject based on the ideXlab platform.

  • a decade of difficult Airway Response team lessons learned from a hospital wide difficult Airway Response team program
    Critical Care Clinics, 2018
    Co-Authors: Lynette Mark, Laeben Lester, Renee Cover, Kurt R Herzer
    Abstract:

    A decade ago the Difficult Airway Response Team (DART) program was created at The Johns Hopkins Hospital as a multidisciplinary effort to address Airway-related adverse events in the nonoperative setting. Root cause analysis of prior events indicated that a major factor in adverse patient outcomes was lack of a systematic approach for responding to difficult Airway patients in an emergency. The DART program encompasses operational, safety, and educational initiatives and has responded to approximately 1000 events since its initiation, with no resultant adult Airway-related adverse events or morbidity. This article provides lessons learned and recommendations for initiating a DART program.

  • difficult Airway Response team a novel quality improvement program for managing hospital wide Airway emergencies
    Anesthesia & Analgesia, 2015
    Co-Authors: Lynette Mark, Renee Cover, Kurt R Herzer, Vinciya Pandian, Nasir I Bhatti, Lauren C Berkow, Elliott R Haut, Alexander T Hillel, Christina Miller, David J Fellerkopman
    Abstract:

    BACKGROUND:Difficult Airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency Airway management outside the operating room is particularly challenging.METHODS:We developed a quality improvement program—the Difficult Airway Response Team (

  • a novel role for otolaryngologists in the multidisciplinary difficult Airway Response team
    Laryngoscope, 2015
    Co-Authors: Alexander T Hillel, Lynette Mark, Renee Cover, Vinciya Pandian, Lauren C Berkow, Elliott R Haut, Christina Miller, James H Clark, Yuri Agrawal, Nasir I Bhatti
    Abstract:

    Objectives/Hypothesis The Difficult Airway Response Team (DART) was implemented in July 2008 to address emergent difficult Airway situations. The main objective of this study was to highlight the unique role and skill set that otolaryngologists bring and their impact on patient outcomes. Study Design Retrospective review of prospectively collected data from the hospital's Airway registry. Methods We collected data on demographics, Airway characteristics, Airway management techniques used by each specialty, and clinical outcomes (such as cricothyrotomies) for patients for whom a code was activated between July 2006 and June 2010. We compared data between pre- and post-DART cohorts and between DART and non-DART patients using a matched case-control approach. Results Of the 2,826 codes, 90 patients required DART management between July 2008 and June 2010. Body mass index, cervical spine injury/fixation, history of difficult Airway, head and neck mass, and oropharyngeal and/or supraglottic angioedema were identified as significant predictors for DART activation. Forty-nine (60%) patients' Airways were secured by anesthesiologists, 30 (36%) by otolaryngologists, and three (4%) by trauma surgeons. Otolaryngologists were able to use specialized techniques such as Holinger and Dedo laryngoscopes to significantly decrease the number of cricothyrotomies from seven (0.73%) pre-DART implementation to four (0.21%) post-DART implementation. Conclusions Otolaryngologists were able to decrease the need for cricothyrotomies using specialized techniques for patients with difficult Airways. Otolaryngologists bring a special skill set to the DART that is beyond the scope of anesthesiologists and trauma surgeons and that can improve patient outcomes by preventing unnecessary emergency surgical Airways. Level of Evidence 2b Laryngoscope, 125:640–644, 2015

Vinciya Pandian - One of the best experts on this subject based on the ideXlab platform.

  • multidisciplinary difficult Airway course an essential educational component of a hospital wide difficult Airway Response program
    Journal of Surgical Education, 2018
    Co-Authors: Robert W Leeper, Vinciya Pandian, Nasir I Bhatti, Elliott R Haut, Sajan Nakka, Jeffrey M Doddo, Elizabeth A Hunt, Mustapha Saheed, Nicholas M Dalesio, Adam Schiavi
    Abstract:

    Objective A hospital-wide difficult Airway Response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult Airway Response team program, known as the multidisciplinary difficult Airway course (MDAC). Design The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in Airway management. The MDAC occurs within the Johns Hopkins Medicine Simulation Center approximately four times per year and uses a combination of didactic lectures, hands-on sessions, and high-fidelity simulation training. Participation in MDAC is the main intervention being investigated in this study. Data were collected prospectively using course evaluation survey with quantitative and qualitative components, and prepost course knowledge assessment multiple choice questions (MCQ). Outcomes include course evaluation scores and themes derived from qualitative assessments, and prepost course knowledge assessment MCQ scores. Setting Tertiary care academic hospital center Participants Students, residents, fellows, and practicing physicians from the departments of Surgery, Otolaryngology Head and Neck Surgery, Anesthesiology/Critical Care Medicine, and Emergency Medicine; advanced practice providers (nurse practitioners and physician assistants), nurse anesthetists, nurses, and respiratory therapists. Results Totally, 23 MDACs have been conducted, including 499 participants. Course evaluations were uniformly positive with mean score of 86.9 of 95 points. Qualitative Responses suggest major value from high-fidelity simulation, the hands-on skill stations, and teamwork practice. MCQ scores demonstrated significant improvement: median (interquartile range) pre: 69% (60%-81%) vs post: 81% (72%-89%), p Conclusions Implementation of a MDAC successfully disseminated principles and protocols to all Airway providers. Demonstrable improvement in prepost course knowledge assessment and overwhelmingly positive course evaluations (quantitative and qualitative) suggest a critical and ongoing role for the MDAC course.

  • difficult Airway Response team a novel quality improvement program for managing hospital wide Airway emergencies
    Anesthesia & Analgesia, 2015
    Co-Authors: Lynette Mark, Renee Cover, Kurt R Herzer, Vinciya Pandian, Nasir I Bhatti, Lauren C Berkow, Elliott R Haut, Alexander T Hillel, Christina Miller, David J Fellerkopman
    Abstract:

    BACKGROUND:Difficult Airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency Airway management outside the operating room is particularly challenging.METHODS:We developed a quality improvement program—the Difficult Airway Response Team (

  • integration of a difficult Airway Response team into a hospital emergency Response system
    Anesthesiology Clinics, 2015
    Co-Authors: Monika Chmielewska, Vinciya Pandian, Bradford D Winters, Alexander T Hillel
    Abstract:

    : Hospital-wide emergency Response teams have been an area of development for several decades. Highly specialized to address emergent needs, they mimic the cardiac-pulmonary arrest teams established at hospitals nationwide, such as heart attack, brain attack, medical emergency, rapid Response, and difficult Airway Response teams (DART). The DART at Johns Hopkins Hospital is a collaboration of the Anesthesiology and Critical Care Medicine, Otolaryngology-Head and Neck Surgery, General Surgery, and Emergency Medicine departments. This successful model may be used by other hospitals to establish improved and comprehensive care of the difficult Airway patient.

  • a novel role for otolaryngologists in the multidisciplinary difficult Airway Response team
    Laryngoscope, 2015
    Co-Authors: Alexander T Hillel, Lynette Mark, Renee Cover, Vinciya Pandian, Lauren C Berkow, Elliott R Haut, Christina Miller, James H Clark, Yuri Agrawal, Nasir I Bhatti
    Abstract:

    Objectives/Hypothesis The Difficult Airway Response Team (DART) was implemented in July 2008 to address emergent difficult Airway situations. The main objective of this study was to highlight the unique role and skill set that otolaryngologists bring and their impact on patient outcomes. Study Design Retrospective review of prospectively collected data from the hospital's Airway registry. Methods We collected data on demographics, Airway characteristics, Airway management techniques used by each specialty, and clinical outcomes (such as cricothyrotomies) for patients for whom a code was activated between July 2006 and June 2010. We compared data between pre- and post-DART cohorts and between DART and non-DART patients using a matched case-control approach. Results Of the 2,826 codes, 90 patients required DART management between July 2008 and June 2010. Body mass index, cervical spine injury/fixation, history of difficult Airway, head and neck mass, and oropharyngeal and/or supraglottic angioedema were identified as significant predictors for DART activation. Forty-nine (60%) patients' Airways were secured by anesthesiologists, 30 (36%) by otolaryngologists, and three (4%) by trauma surgeons. Otolaryngologists were able to use specialized techniques such as Holinger and Dedo laryngoscopes to significantly decrease the number of cricothyrotomies from seven (0.73%) pre-DART implementation to four (0.21%) post-DART implementation. Conclusions Otolaryngologists were able to decrease the need for cricothyrotomies using specialized techniques for patients with difficult Airways. Otolaryngologists bring a special skill set to the DART that is beyond the scope of anesthesiologists and trauma surgeons and that can improve patient outcomes by preventing unnecessary emergency surgical Airways. Level of Evidence 2b Laryngoscope, 125:640–644, 2015

Nasir I Bhatti - One of the best experts on this subject based on the ideXlab platform.

  • multidisciplinary difficult Airway course an essential educational component of a hospital wide difficult Airway Response program
    Journal of Surgical Education, 2018
    Co-Authors: Robert W Leeper, Vinciya Pandian, Nasir I Bhatti, Elliott R Haut, Sajan Nakka, Jeffrey M Doddo, Elizabeth A Hunt, Mustapha Saheed, Nicholas M Dalesio, Adam Schiavi
    Abstract:

    Objective A hospital-wide difficult Airway Response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult Airway Response team program, known as the multidisciplinary difficult Airway course (MDAC). Design The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in Airway management. The MDAC occurs within the Johns Hopkins Medicine Simulation Center approximately four times per year and uses a combination of didactic lectures, hands-on sessions, and high-fidelity simulation training. Participation in MDAC is the main intervention being investigated in this study. Data were collected prospectively using course evaluation survey with quantitative and qualitative components, and prepost course knowledge assessment multiple choice questions (MCQ). Outcomes include course evaluation scores and themes derived from qualitative assessments, and prepost course knowledge assessment MCQ scores. Setting Tertiary care academic hospital center Participants Students, residents, fellows, and practicing physicians from the departments of Surgery, Otolaryngology Head and Neck Surgery, Anesthesiology/Critical Care Medicine, and Emergency Medicine; advanced practice providers (nurse practitioners and physician assistants), nurse anesthetists, nurses, and respiratory therapists. Results Totally, 23 MDACs have been conducted, including 499 participants. Course evaluations were uniformly positive with mean score of 86.9 of 95 points. Qualitative Responses suggest major value from high-fidelity simulation, the hands-on skill stations, and teamwork practice. MCQ scores demonstrated significant improvement: median (interquartile range) pre: 69% (60%-81%) vs post: 81% (72%-89%), p Conclusions Implementation of a MDAC successfully disseminated principles and protocols to all Airway providers. Demonstrable improvement in prepost course knowledge assessment and overwhelmingly positive course evaluations (quantitative and qualitative) suggest a critical and ongoing role for the MDAC course.

  • difficult Airway Response team a novel quality improvement program for managing hospital wide Airway emergencies
    Anesthesia & Analgesia, 2015
    Co-Authors: Lynette Mark, Renee Cover, Kurt R Herzer, Vinciya Pandian, Nasir I Bhatti, Lauren C Berkow, Elliott R Haut, Alexander T Hillel, Christina Miller, David J Fellerkopman
    Abstract:

    BACKGROUND:Difficult Airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency Airway management outside the operating room is particularly challenging.METHODS:We developed a quality improvement program—the Difficult Airway Response Team (

  • a novel role for otolaryngologists in the multidisciplinary difficult Airway Response team
    Laryngoscope, 2015
    Co-Authors: Alexander T Hillel, Lynette Mark, Renee Cover, Vinciya Pandian, Lauren C Berkow, Elliott R Haut, Christina Miller, James H Clark, Yuri Agrawal, Nasir I Bhatti
    Abstract:

    Objectives/Hypothesis The Difficult Airway Response Team (DART) was implemented in July 2008 to address emergent difficult Airway situations. The main objective of this study was to highlight the unique role and skill set that otolaryngologists bring and their impact on patient outcomes. Study Design Retrospective review of prospectively collected data from the hospital's Airway registry. Methods We collected data on demographics, Airway characteristics, Airway management techniques used by each specialty, and clinical outcomes (such as cricothyrotomies) for patients for whom a code was activated between July 2006 and June 2010. We compared data between pre- and post-DART cohorts and between DART and non-DART patients using a matched case-control approach. Results Of the 2,826 codes, 90 patients required DART management between July 2008 and June 2010. Body mass index, cervical spine injury/fixation, history of difficult Airway, head and neck mass, and oropharyngeal and/or supraglottic angioedema were identified as significant predictors for DART activation. Forty-nine (60%) patients' Airways were secured by anesthesiologists, 30 (36%) by otolaryngologists, and three (4%) by trauma surgeons. Otolaryngologists were able to use specialized techniques such as Holinger and Dedo laryngoscopes to significantly decrease the number of cricothyrotomies from seven (0.73%) pre-DART implementation to four (0.21%) post-DART implementation. Conclusions Otolaryngologists were able to decrease the need for cricothyrotomies using specialized techniques for patients with difficult Airways. Otolaryngologists bring a special skill set to the DART that is beyond the scope of anesthesiologists and trauma surgeons and that can improve patient outcomes by preventing unnecessary emergency surgical Airways. Level of Evidence 2b Laryngoscope, 125:640–644, 2015

Renee Cover - One of the best experts on this subject based on the ideXlab platform.

  • a decade of difficult Airway Response team lessons learned from a hospital wide difficult Airway Response team program
    Critical Care Clinics, 2018
    Co-Authors: Lynette Mark, Laeben Lester, Renee Cover, Kurt R Herzer
    Abstract:

    A decade ago the Difficult Airway Response Team (DART) program was created at The Johns Hopkins Hospital as a multidisciplinary effort to address Airway-related adverse events in the nonoperative setting. Root cause analysis of prior events indicated that a major factor in adverse patient outcomes was lack of a systematic approach for responding to difficult Airway patients in an emergency. The DART program encompasses operational, safety, and educational initiatives and has responded to approximately 1000 events since its initiation, with no resultant adult Airway-related adverse events or morbidity. This article provides lessons learned and recommendations for initiating a DART program.

  • difficult Airway Response team a novel quality improvement program for managing hospital wide Airway emergencies
    Anesthesia & Analgesia, 2015
    Co-Authors: Lynette Mark, Renee Cover, Kurt R Herzer, Vinciya Pandian, Nasir I Bhatti, Lauren C Berkow, Elliott R Haut, Alexander T Hillel, Christina Miller, David J Fellerkopman
    Abstract:

    BACKGROUND:Difficult Airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency Airway management outside the operating room is particularly challenging.METHODS:We developed a quality improvement program—the Difficult Airway Response Team (

  • a novel role for otolaryngologists in the multidisciplinary difficult Airway Response team
    Laryngoscope, 2015
    Co-Authors: Alexander T Hillel, Lynette Mark, Renee Cover, Vinciya Pandian, Lauren C Berkow, Elliott R Haut, Christina Miller, James H Clark, Yuri Agrawal, Nasir I Bhatti
    Abstract:

    Objectives/Hypothesis The Difficult Airway Response Team (DART) was implemented in July 2008 to address emergent difficult Airway situations. The main objective of this study was to highlight the unique role and skill set that otolaryngologists bring and their impact on patient outcomes. Study Design Retrospective review of prospectively collected data from the hospital's Airway registry. Methods We collected data on demographics, Airway characteristics, Airway management techniques used by each specialty, and clinical outcomes (such as cricothyrotomies) for patients for whom a code was activated between July 2006 and June 2010. We compared data between pre- and post-DART cohorts and between DART and non-DART patients using a matched case-control approach. Results Of the 2,826 codes, 90 patients required DART management between July 2008 and June 2010. Body mass index, cervical spine injury/fixation, history of difficult Airway, head and neck mass, and oropharyngeal and/or supraglottic angioedema were identified as significant predictors for DART activation. Forty-nine (60%) patients' Airways were secured by anesthesiologists, 30 (36%) by otolaryngologists, and three (4%) by trauma surgeons. Otolaryngologists were able to use specialized techniques such as Holinger and Dedo laryngoscopes to significantly decrease the number of cricothyrotomies from seven (0.73%) pre-DART implementation to four (0.21%) post-DART implementation. Conclusions Otolaryngologists were able to decrease the need for cricothyrotomies using specialized techniques for patients with difficult Airways. Otolaryngologists bring a special skill set to the DART that is beyond the scope of anesthesiologists and trauma surgeons and that can improve patient outcomes by preventing unnecessary emergency surgical Airways. Level of Evidence 2b Laryngoscope, 125:640–644, 2015