A Decade of Difficult Airway Response Team: Lessons Learned from a Hospital-Wide Difficult Airway Response Team Program

Lynette Mark; Laeben Lester; Renee Cover; Kurt Herzer

doi:10.1016/j.ccc.2017.12.008

A Decade of Difficult Airway Response Team: Lessons Learned from a Hospital-Wide Difficult Airway Response Team Program

Crit Care Clin. 2018 Apr;34(2):239-251. doi: 10.1016/j.ccc.2017.12.008. Epub 2018 Feb 1.

Authors

Lynette Mark¹, Laeben Lester², Renee Cover³, Kurt Herzer⁴

Affiliations

¹ Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine Multidisciplinary Airway Programs, Difficult Airway Response Team (DART) Program, Johns Hopkins Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine Multidisciplinary Airway Programs, Difficult Airway Response Team (DART) Program, Johns Hopkins Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA. Electronic address: lmark@jhmi.edu.
² Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine Multidisciplinary Airway Programs, Johns Hopkins Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA; Department of Emergency Medicine, Johns Hopkins Medicine Multidisciplinary Airway Programs, Johns Hopkins Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA.
³ Johns Hopkins Health System Legal Department, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287, USA.
⁴ Oscar Health, 219 Withers Street, Brooklyn, NY 11211, USA.

PMID: 29482903
DOI: 10.1016/j.ccc.2017.12.008

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.

Keywords: Difficult airway patient; Difficult airway registry; Difficult airway response team; Hospital difficult airway alert systems; Multidisciplinary airway management; Rapid response teams; Second victim; Simulation-based medical education.

Publication types

Evaluation Study
Review

MeSH terms

Adult
Aged
Aged, 80 and over
Airway Management / methods
Airway Management / standards*
Baltimore
Emergency Medical Services / methods
Emergency Medical Services / standards*
Female
Hospital Rapid Response Team / standards*
Humans
Intubation, Intratracheal / methods
Intubation, Intratracheal / standards*
Male
Middle Aged
Practice Guidelines as Topic*