Download - National Audit Project Four
National Audit Project National Audit Project FourFour
NAP4NAP4
What is NAP4?
A national audit of major complications of airway management
in the UK
Why?
To determine the incidence of serious complications of airway management in UK anaesthetic practice
To look for themes and to learn from adverse events
Number of Complications_________________________________________________________________________________
Number of Airway Interventions
Within a given time period
Incidence?
How many anaesthetics are performed per year in the UK?
Not known
No data = No denominator
Snapshot of current practice needed
NAP4 needs two phases
Phase 1• A snapshot of practice• Over a 2 week period• During September 2008• Provides denominator
Phase 2• Study of complications• Over one year• 01/09/2008 - 31/08/2009• Provides numerator
Number of complications_________________________________________________________________________________
Number of Airway Interventions
NAP4 needs two phases
Phase 1• A snapshot of practice• Over a 2 week period• During September 2008• Provides denominator
Phase 2• Study of complications• Over one year• 01/09/2008 - 31/08/2009• Provides numerator
Number of complications_________________________________________________________________________________
Number of Airway Interventions
Phase 1- The Snapshot
Data Collection
• All anaesthetics in a hospital
• Over the same 2 week period
• Submit data on clinical activity• Number of general or regional anaesthetics• Airway management of cases under GA
• All hospitals in the UK
• Co-ordinated by the Local Reporter
Local Reporters
Used for NAP3 – Central neuraxial blockade
• Have an essential central role
• Disseminate information
• Collect data - snapshot
• Support local anaesthetists
• Aid reporting of adverse airway events in phase 2
Phase 2 –Airway Complications
Data Collection
• Starts 1st September 2008
• Runs for 1 year
• Notify RCoA /Tim Cook by email
• Online data submission
What sort of Complications?
Inclusion Criteria
• Death
• Brain damage
• Emergency surgical airway
• ICU admission resulting from an airway management complication
Emergency Surgical Airway
Includes
• Emergency Cricothyroidotomy– Needle– Cannula
• Emergency surgical airway – Cricothyroidotomy– Tracheostomy
Example cases for inclusion• Post extubation stridor requiring re-intubation
and ICU admission• Elective ventilation following hypoxic cardiac
arrest due to an airway problem during anaesthesia
• ICU admission following aspiration of gastric contents during an operation
ICU Admission Resulting from an Airway Management Complication
ICU Admission Resulting from an Airway Management Complication
Example of cases for exclusion
• ICU Admission for unrelated reasons• ICU Admission because HDU was full• HDU admission following aspiration of gastric
contents with complete resolution
When does it start?
• Snapshot of current practice– 2 week period September/October 2008
• One year data collection process– 01/09/2008 to 30/08/2009
Airway Problems ElsewhereMeeting Inclusion Criteria
• Intensive Care Unit – Inform NAP4• Emergency Department – Inform NAP4• Hospital wards - Do not inform NAP4• Pre-hospital care - Do not inform NAP4• If an anaesthetic is involved
Anywhere in the hospital – Inform NAP4
Notification of Events
• Anyone may inform the college of events
• Inform the RCoA lead – Tim Cook [email protected]
• A username will be issued to enable on-line data submission via the DAS web-site
• Data submission is required to be anonymous
All you need to remember is..
• If you know of an airway problem resulting in:– Death – Brain damage – Emergency surgical airway– ICU admission resulting from an airway
management complication
• Inform Tim Cook [email protected] • Send no patient details
Approval
The process has been approved by
• NRES National Research Ethics Service
• PIAG Patient Information Advisory Group
• CMOUK Chief Medical Officers
Supported by• Royal College of Anaesthetists• Difficult Airway Society• National Patient Safety Agency• Association of Anaesthetists of Great Britain and Ireland, • Association for Peri-Operative Practice• Association of Paediatric Anaesthetists • College of Emergency Medicine • College of Operating Department Practitioners• Intensive Care Society• Intensive Care National Audit and Research Centre• Obstetric Anaesthetists Association • Paediatric Intensive Care Society• Paediatric Intensive Care network • All Chief Medical Officers • Medical Defence organisations
More Information – RCoA Web-site
More Information - DAS Web-site
More Information
RCoA Bulletin September 2008
Anaesthesia NewsSeptember 2008
More Information - Posters
Appearing soon!
•Anaesthesia departments
•Intensive Care Units
•Emergency departments
Thanks for your support
The End
