Date of Award

Spring 5-1-2022

Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Brian Garrett, DNP, CRNA

First Committee Member

Kacy Ballard, DNP, CRNA

Second Committee Member

Greg Stockton, DNP, CRNA


Neuromuscular Blocking Agents, Airway Training, Airway Management, Endotracheal Intubation

Subject Categories

Medicine and Health Sciences


Emergency endotracheal intubations occurring outside of the Operating Room (OR) are often performed by non-anesthesia providers. At a large, urban, level one trauma center, the current airway management policy for these non-anesthesia providers does not follow best practices based on the literature. Specifically, some non-anesthesia providers are not credentialed and/or privileged to administer neuromuscular blocking agents (NMBAs) during emergency endotracheal intubations. The purpose of this project was to develop evidence-based clinical recommendations for emergency airway management outside of the OR. The following objectives are framed using the Johns Hopkins Evidence-Based Practice (EBP) Model and were established to achieve the projects overall aim: 1) synthesize the evidence around the use of NMBAs during emergency airway management, 2) develop evidence-based recommendations for emergency airway management training, and 3) develop a comprehensive plan on how to enact and monitor recommendations for effectiveness. This project was significant because it provided a blueprint for clinical practice changes that could be adopted and implemented to improve patient outcomes. The project created evidence-based recommendations to optimize outcomes and enhance training for these providers requiring credentialing. In addition, the project included the development of a plan to monitor and measure the recommendations for effectiveness, as well as the development of a plan for adjusting/changing recommendations if identified as ineffective. These plans are outside the scope of the project’s academic/curricular timeline and would be implanted by the facility.

Licensing Permission

Copyright, all rights reserved. Fair Use



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.