ORCID

https://orcid.org/0000-0001-8769-9245

Date of Award

Spring 4-28-2024

Document Type

Paper

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Advisor

Dr. Brian Garrett, DNP, CRNA

First Committee Member

Dr. Chai Sribanditmongkol, PhD, RN, IBCLC, CNS

Second Committee Member

Dr. Amy Bishop, DNP, AGCNS

Keywords

Angioedema, Guideline, Anesthesia, Emergency Room, Emergency Department, Difficult Airway Team, Airway Management, Angioedema Protocol/Guideline/Procedure/Policy

Subject Categories

Anesthesia and Analgesia | Congenital, Hereditary, and Neonatal Diseases and Abnormalities | Diagnosis | Equipment and Supplies | Immune System Diseases | Medicine and Health Sciences | Perioperative, Operating Room and Surgical Nursing | Respiratory System | Surgical Procedures, Operative

Abstract

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for AE to facilitate a quality improvement project for guideline implementation. The proposed guideline offers medication choices for AE patients, steps for providers to follow when presented with an AE case, and suggests intubation and emergency surgical airway techniques. Project implementation involves retrospective and prospective chart reviews, in person staff training, and the creation of an angioedema cart containing all necessary medications and intubation supplies suggested in the guideline. The project also supplies an infographic algorithm for quick use, with separate task lists for ED and anesthesia providers. If implemented, the full proposed timeline for training and data gathering would be one year, with the outcomes of patient mortality, hypoxic brain injury, cardiac arrest, and airway placement metrics to be assessed via chart review pre and post guideline implementation. The project emphasizes the importance of successfully managing AE and the guideline hopes to serve as a quick resource to providers dealing with emergent AE airway issues.

Acknowledgement 1

1

Acknowledgement 2

1

Licensing Permission

Copyright, some rights reserved. Attribution – Noncommercial – No Derivative Works

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