“To Air is Human”

Lessons From The Air Karel Habig

No Disclosures

Safety inMedicine?

•Pic of AW139 cockpit

PlaneCrashInfo.com

Boeing 2010

Accident Rate by Aircraft Generation

•Cockpit vs RESUS bay

•Aviation Safety beyond CRM

•NONtechnical Factors

•ENGINEERED SAFETY

•STANDARD OPERATING PROCEDURES

•CHECKLISTS

•TYPE RATINGS CURRENCIES AND LINE CHECKS

•REPORTING SYSTEMS

•Interhospital patient

QuickTime™ and aH.264 decompressor

are needed to see this picture.

QuickTime™ and aH.264 decompressor

are needed to see this picture.

•PAED RSI

Assumption

No policy

‘Difficult’ airway

Equipmentlocation

Criticaldesaturation

Decision tointubate

•Aviation Safety beyond CRM

•NONtechnical Factors

•ENGINEERED SAFETY

•STANDARD OPERATING PROCEDURES

•CHECKLISTS

•TYPE RATINGS CURRENCIES AND LINE CHECKS

•REPORTING SYSTEMS

PATIENT PREPARATION

EQUIPMENT REDUNDANCY

IV x 2

Suction x 2

ETCO2 x 2

Laryngoscopes/ Blades/Tubes x 2

•Equipment

STANDARD SET-UP

INDUCTION SAFETY

•Training

•RSI Currency

SIMULATION

BACKUP PLAN

DailyCase review

Coffee n Cases24 hr Follow Up

FortnightlyClinical Governance

DaysCase presentations

MonthlyM&M

Clinical KPIsAirway Audit

QuarterlyInduction trainingClinical Currencies

Its all about First Look...

380 PREHOSPITAL RSIs 2009-2012

Overall >99% intubations successful

91% on First Look

Google “Sydney hems”

Email: KHabig@ambulance.nsw.gov.au