(0803) Choosing Endotracheal Tube Size in Adults: A Quality Improvement Project at a Community Hospital

Introduction: Postintubation airway injury is a well-recognized complication. Risk factors, including endotracheal tube size (ETT), have been clearly elucidated. An increase in average ETT size and new postintubation airway stenosis diagnoses were noted at a community hospital. We aim to gauge our non-ENT colleagues’ familiarity with post-intubation airway injuries and provide education to improve patient outcomes.

Methods: This is a quality improvement (QI) project. The intervention was a presentation on intubation-related airway stenosis given to the following groups: internal medicine (IM/ICU), anesthesia (ANES), and emergency medicine (EM). A survey was given before and after the presentation. Outcomes include survey responses before vs after education, including confidence level on question A (ability to choose appropriately sized ETT) and B (understanding consequences of failure to do so), and score on content questions.

Results: There were 87 participants, with 23 IM/ICU, 28 ANES, and 36 EM. Training levels ranged from medical student to attending, with the majority (34.5%) being post-graduate year 2. All groups improved in their confidence levels from 2.32 (somewhat) to 1.52 (somewhat) on question A (p < 0.001), and 1.93 (somewhat) to 1.09 (yes absolutely) on question B (p < 0.001). All groups improved their content scores as well, from an overall mean of 51.9% to 73.5% (p < 0.001).

Conclusions: This QI study focused on intubation-related airway stenosis education. Analysis of survey results showed an improvement in confidence levels and scores. This study suggests that our educational efforts were successful and will hopefully lead to improved airway outcomes.