Checklists

Since Peter Pronovost’s landmark study on how a simple checklist can nearly abolish central line infections, checklists have been the darling of the medical literature. But central lines generally are for elective procedures, allowing us the time and patience to run through the list. Can we gain the same safety and cognitive benefits in an adrenaline-laden procedure like intubation? Hell yeah!

It all starts with the EMCrit Intubation Checklist

Download the checklist

The Components
HOp Killers

Here is the wee on the HOp Killers: Hemodynamic Kills, Oxygenation Kills, and pH Kills

• 
  
• Intubating the Hemodynamically Unstable Patient
  
• Intubating the Patient at Risk for Critical Hypoxemia
  
• Intubating the Patient with Metabolic Acidosis
  

RSI or Awake? · DSI? · RSA? · ICP/Vascular?

• 
  
• Awake Intubation Lecture
  
• Awake Intubation Video
  
• More info on Delayed Sequence Intubation (DSI)
  
• Rapid Sequence Airway (RSA)
  
• ICP/Vascular Intubation
  

Are the peri-intubation medications ready?

Push-Dose Pressors

• 
  
• Push-Dose Pressor Podcast and Mixing Sheet
  

What is the plan for unexpected difficult or failed airway?

• 
  
• I use a modified version of the Shock Trauma Center Failed Airway Algorithm
  
• Cook Gas ILA (My preferred Extraglottic Airway)
  

Can the cricothyroid membrane be palpated?

• 
  
• Cric-Con Approach to Cricothyrotomy Preparation
  

What is the plan for post-intubation sedation?

• 
  
• A bad sedation package traps your patient in a nightmare
  

Is the patient positioned adequately?
from AirwayCam Site
Would the patient benefit from pre-intubation NGT?

• 
  
• Intubating the GI Bleeder
  

Skills of Intubation
Laryngoscopy

Cricothyrotomy

Video

Bougie-Aided Cricothyrotomy

Video

Post Intubation Management

• 
  
• Ventilator Lecture
  
• The Package
  

Building Checklists

The Checklist Project and their Checklist for Checklists

Other People’s Intubation Checklists for Inspiration

The EMCrit checklist drew inspiration and aid from these other checklists. Shoulders of giants and such…

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Finally… The EMCrit Call/Response VodCast is done. Podcast 92: emcrit.org/podcasts/emcri… Now tear it apart and make it better!

— Scott Weingart (@emcrit) February 5, 2013

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Now, on to the podcast…

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