Table 3

Specific content analysis for 19 ‘standard’ prehospital emergency anaesthesia (PHEA) checklists used in the UK

Safety checkCheck included?Other comments RE-specific checks
Optimisation of patient /conditions
 Plan for difficult/failed airway verbalised?8 (42%)

  • Reminder to state difficult airway plan n=1

  • Reminder to verbalise predicted difficult airway n=1

 Patient position (eg, trolley at correct height)?3 (16%)
 Patient physiology8 (42%)

  • Reminder to ‘optimise pre-oxygenation’ n=1

  • Check that ‘pre-oxygenation’ occurs n=8

 Reminder to consider if thoracostomy required?5 (26%)
Standard equipment
 Oxygen store check?15 (79%)

  • Back-up O2 cylinder n=7

 Patient monitoring19 (100%)

  • BP/O2 sats monitoring=15

  • BP/O2 sats/continuous ECG n=6

  • Rapid cycling of BP measurement n=3

  • Check just stating for ‘monitor’ and/or ‘baseline obs’ n=4

 Capnography available?18 (95%)

  • Verification of working capnopgraphy n=1

  • Verification that capnography is ‘ready/connected’ n=17

 Stethoscope11 (58%)
 Suction available?19 (100%)

  • Verification of working suction n=7

  • Reserve suction available n=9

 Nasal cannulae for apnoeic oxygenation?1 (5%)
 Portable ventilator?8 (42%)

  • Verification of working ventilator n=1

  • Verification that ventilator settings checked n=2

 Circuit equipment?12 (63%)

  • Filter/HME n=12

  • Catheter mount n=5

Airway equipment
 Laryngoscope check?19 (100%)

  • Verification of working bulb n=17

 Alternative laryngoscope available?10 (53%)
 Mention of tracheal tube?18 (95%)

  • Correct tube size selected n=14

  • Verification of cuff working n=14

 Alternative tube available?12 (63%)
 Tube tie and/or holder17 (89%)
 Syringe for cuff15 (79%)
 Airway adjuncts (eg, oropharyngeal airway)15 (79%)
 Rescue/difficult airway kit available?18 (95%)

  • Specific supraglottic airway available n=15

  • Airtraq device available n=1

Intravenous access/drugs
 Drugs?19 (100%)

  • Specific drug(s) dose chosen n=13

  • Specific drug(s) volume chosen n=3

 Intravenous access19 (100%)

  • 2 intravenous lines cited n=15

  • Verification that lines patent n=14

 Emergency/resuscitation drugs check?7 (37%)

  • Specific drug(s) mentioned n=3

  • Drug class mentioned (eg, alpha agonist) n=1

 Maintenance of anaesthesia post-PHEA check6 (32%)

  • Specific drugs mentioned n=0

Team brief
 Team brief check?19 (100%)

  • MILS briefed n=12

  • Drug giver briefed n=9

  • Cricoid pressure/airway assistant briefed n=17

  • Data presented as number of checklists that included specific check (%).

  • HME, heat moisture exchange; MILS, manual inline stabilisation.