Mid-Arm Point in PAEDiatrics (MAPPAED): An effective procedural aid for safe pleural decompression in trauma.

Objective: Life-threatening thoracic trauma requires emergency pleural decompression and thoracostomy and chest drain insertion are core trauma procedures. Reliably determining a safe site for pleural decompression in children can be challenging. We assessed whether the Mid-Arm Point (MAP) technique, a procedural aid proposed for use with injured adults, would also identify a safe site for pleural decompression in children.

Debriefing immediately after intubation in a children's emergency department is feasible and contributes to measurable improvements in patient safety.

Objective: In 2013, our intubations highlighted a safety gap - only 49% achieved first-pass success without hypoxia or hypotension. NAP4 recommended debriefing after intubation, but limited published methods existed. Primary aim is to implement a feasible process for immediate debriefing and feedback for emergency airway management.

A quality improvement initiative to increase the safety of pediatric emergency airway management.

Background: Emergency airway management is commonly associated with life-threatening hypoxia and hypotension which may be preventable.

Aims: The aim of this quality improvement study was to reduce the frequency of intubation-related hypoxia and hypotension.

Methods: This prospective quality improvement study was conducted over 4 years in the Emergency Department of The Royal Children's Hospital, Melbourne, Australia.