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Intubation drug pack containing pre-filled syringes reduces the time to endotracheal intubation in a simulated paediatric emergency
  1. Sara Lawson,
  2. Christopher Flannigan,
  3. Carolyn Green,
  4. Lynsey Freeburn,
  5. Anne Burns,
  6. Joseph McCann,
  7. Thomas Bourke
  1. PICU, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
  1. Correspondence to Dr Sara Lawson, Royal Belfast Hospital for Sick Children, Belfast BT12 6BA, UK; slawson01{at}


To determine if an intubation drugs pack containing pre-filled syringes can reduce the time to endotracheal intubation compared with standard care during a simulated paediatric emergency. Twenty doctors (10 consultants and 10 registrars) who worked in the paediatric intensive care unit or anaesthetic department of a tertiary paediatric hospital were asked to participate in an in situ simulated emergency paediatric intubation scenario. The participants were instructed to prepare and administer intubation medications. They were randomised to either an intubation drug pack, containing pre-filled syringes or to standard care where each of the drugs had to be individually drawn-up. The mean time to intubation when using the pre-filled syringes of 159.5 s was over three times faster than with standard care of 497.5 s (p<0.001), allowing intubation to occur on average 5 min and 38 s earlier. Utilising an intubation drug pack containing pre-filled syringes significantly reduced the time from decision to intubate to intubation in a simulated paediatric emergency. This applied irrespective of clinical experience with registrars utilising the pre-filled syringes outperforming consultant anaesthetists when they used standard care.

  • in situ simulation
  • pre-filled syringes
  • intubation
  • paediatrics

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  • Contributors SL, CF, CG and TB designed the scenario. SL, CF and LF conducted the study. All authors contributed to the conception of the study, revision of the manuscript and final approval of the version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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