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Record W4411194291 · doi:10.1016/j.afjem.2025.03.002

Implementing the Safe Airway Checklist (SAC) at the emergency department of a major teaching hospital in Rwanda: A pre- and post-intervention study

2025· article· en· W4411194291 on OpenAlexaff
Joseph Biramahire, M. Graça Pereira, Appolinaire Manirafasha, Doris Uwamahoro, Jean Paul Mvukiyehe, Paulin Banguti, Eugène Tuyishime

Bibliographic record

VenueAfrican Journal of Emergency Medicine · 2025
Typearticle
Languageen
FieldMedicine
TopicAirway Management and Intubation Techniques
Canadian institutionsWestern University
Fundersnot available
KeywordsMedicineChecklistAirway managementIntubationEmergency departmentAirwayEmergency medicineIntervention (counseling)PremedicationIntensive care medicineAnesthesiaNursing

Abstract

fetched live from OpenAlex

Background: Airway management is a critical aspect of emergency care, and adherence to standardized protocols can improve patient outcomes. However, in resource-limited settings such as Rwanda, the implementation of airway management protocols in the emergency department (ED) may face challenges. This study aims to evaluate the impact of implementing the Safe Airway Checklist (SAC) on airway management practices and post-intubation complications in a major teaching hospital in Rwanda. Methods: A pre- and post-intervention study design was used to assess the impact of the SAC on intubation practices and post-intubation checklist in the ED at the University Teaching Hospital of Kigali. The study included a baseline assessment of residents' intubation practices, followed by implementation of the SAC, and post-implementation data collection to evaluate changes in adherence to airway management practices and post-intubation complications. Results: Among 77 intubation (40 pre-intervention and 37 post-intervention), the implementation of the SAC led to improvement in 4 key airway management practices (airway cart and glidescope setup, premedication use, restraining patients, and checking ABG within 10-15 min) in the ED. However, the reduction in rates of post-intubation complications was not statistically significant. Conclusion: The implementation of the Safe Airway Checklist in the ED of a major teaching hospital in Rwanda significantly improved several critical aspects of airway management. While no statistically significant reduction in post-intubation complications were observed, the decreasing trend of complication rates suggests promising benefits that merit further exploration. These findings highlight the value of standardized checklists in enhancing clinical practices and underscore the need for ongoing research to fully understand their impact on patient outcomes especially in low resources settings.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.159
Threshold uncertainty score0.998

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0040.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0030.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.013
GPT teacher head0.332
Teacher spread0.319 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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