The nature of the response to reported incidents in airway management - a scoping review

AbstractObjective: This scoping review aims to investigate the response in human airway management in high-income countries to findings of reported airway incidents.Introduction:Airway management uses techniques and devices to maintain or restore a patent airway for the purpose of oxygen delivery and carbon dioxide excretion. Airway incidents are rare but can cause significant patient harm and death within minutes. Incident reporting has been relied on in the field of anaesthetics, emergency medicine and intensive care medicine with multiple nationwide audits, case series and incident analyses relating to airway incidents reported in the last three decades.Inclusion criteria:Papers will be included if they focus on real events in airway management in humans, document findings from incident reports, audits, closed claimed studies or case series from high-income countries, and are published from 1990.Methods:The JBI Scoping Review guidance will be followed. Search terms have been developed using the PCC system. Pubmed, Ovid's Medline, Embase, JBI, SCOPUS and the Cochrane Library will be searched for articles that meet inclusion criteria. Additional databases may be added, and websites of airway management societies will be searched for gray literature. The search strategy will be displayed using a PRISMA flow diagram. All study designs will be considered and screened independently by two reviewers. The final relevant full text articles will be reviewed by all authors. Gaps in the literature will be analysed and documented and implemented system changes will be described and discussed.

摘要 研究目的：本范围综述旨在调查高收入国家针对已报道气道事件的人类气道管理应对措施。

引言：气道管理通过各类技术与设备维持或重建通畅气道，以实现氧气输送与二氧化碳排出。气道事件虽罕见，但可在数分钟内对患者造成严重损害甚至死亡。近三十年来，麻醉学、急诊医学与重症医学领域已依托事件报告开展多项全国性审计、病例系列研究及气道事件分析。

纳入标准：纳入以下文献：聚焦人类气道管理中的真实事件，记录来自高收入国家的事件报告、审计、结案索赔研究或病例系列的研究结果，且发表于1990年及之后的文献。

研究方法：本研究遵循乔安娜·布里格斯研究所（JBI）范围综述指南。检索策略基于PCC（人群、概念、背景）框架制定。将在PubMed、Ovid Medline、Embase、JBI数据库、Scopus及Cochrane图书馆中检索符合纳入标准的文献，亦可新增其他数据库，并将检索气道管理学会官网以获取灰色文献。检索流程将采用PRISMA流程图展示。所有研究设计均将被纳入考量，并由两名评审员独立筛选。最终符合要求的全文文献将由全体作者共同审阅。将分析并记录现有文献的研究缺口，并对已实施的系统改进措施进行阐述与讨论。