HAWT Rounds
What is the airway card and what does it tell you?
Laminated card on ventilator showing history of ETT position and retaping.
What are some reasons to re-secure an ETT?
Securement device adhesive is lifting or has been soiled with emesis.
Who should attend a group debrief?
The fellow (leader), bedside RN and RT are required but can also include others involved in the UPE.
What is the minimum number of staff needed at bedside for high risk situations?
2
What is the Job Aid and what does it tell you?
Tool hung in the room of all intubated patients with positioning guidelines for bedside imaging and procedures.
What is optimal positioning for chest x-rays?
Tube is secure, marking at lip is confirmed and chin is neutral.
When should a group debrief occur?
Within 1 hour of the UPE event.
What are some High Risk Situations requiring 2 providers at the bedside?
Repositioning, transferring, ETT re-taping, eye exams, etc.
When do airway rounds occur?
Every Monday and Thursday at 12pm
What is the external anatomical landmark to visualize tube placement? (ie: tube is secured at 9cm at the __)
Outer lip
Who fills out the debrief form?
Ideally the RT since the RT will be the one inputting the incident report.
What is the order in which morning x-rays should be done?
Green Zone, Orange Zone, Blue Zone then Yellow Zone
What are some things discussed in airways rounds?
Tube securement, frequency of re-taping/repositioning, RN/RT concerns
What are our top contributing factors for UPE?
Frequent emesis, inadequate sedation, securement device loose.
Where is the debrief form located?
It is digital! But can be also be completed using form in blue storage room.
CXR: what do you think?
See PPT.