Critical Care Paediatric Grab Bag - Improving the quality of care by improving design

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Purpose/Problem

We ascertained that there could be an improvement in rapid accessibility of emergency equipment required for intubation and ventilation if there was a logical layout of the DCC Paediatric Grab Bag. Previous ‘transfer bag’ had bulky design, was excessive in weight with poor organisation and presence of non-emergency equipment (Photo 1).

Method

The transfer bag was reorganised and newly labelled (Photo 2). Compartments for paediatric intravenous (IV) access, defibrillation pads, intubation essentials, paediatric airway equipment organised in age/weight fashion were included. The airway equipment was ordered into 5 categories/pouches: neonate, infant, preschool, primary school, big child. Non-emergency stock was removed from the bag. A new checklist was devised (Figure 1) to aid with re-stocking after use and to ensure all equipment is checked after each use. A tag system on all the zips has been implemented to advise when the bag was last checked and subsequently sealed.

Results

DCC staff informally report a greater level of satisfaction with the new style of transfer bag and with this a greater confidence in managing airway emergencies in non-theatre environment. This increasing confidence seems to stem from the fact that staff will be able to access emergency equipment in a constant and familiar format.

Conclusion

Complications and delays in airway management due to unfamiliarity with emergency equipment should be avoidable. The re-organisation of the Critical Care paediatric ‘grab bag’ appears to be a relatively simple but effective intervention in improving safety of providing airway management for a paediatric patient.