{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T09:17:31Z","timestamp":1778923051141,"version":"3.51.4"},"reference-count":52,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>A \u201cCode Blue\u201d is a term to activate an alarm for the resuscitation team for a patient who has a cardiopulmonary arrest. The role of a pediatric otolaryngologist in a tracheostomy\u2010related code blue case is not clearly defined. We aim to describe the role of pediatric otolaryngologists in pediatric tracheostomy code blue (PTCB) cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analyzed pediatric code blue cases in a tertiary care hospital from January 2019 to December 2022, before and after the implementation of a standardized PTCB that includes a pediatric otolaryngologist in the resuscitation team. Primary outcome variables included response time and survival\u2010to\u2010discharge of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The most common reason for code activation was reduced oxygen saturation. The leading cause for the otolaryngology consultation was tube blockage. Tracheostomy tube change was the most common intervention performed. The mean time of otolaryngology arrival was significantly decreased from 14.0\u2009min pre\u2010implementation to 4.0\u2009min post\u2010implementation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). While including all 48 PTCB events, pediatric otolaryngologist involvement was significantly associated with higher survival\u2010to\u2010discharge (94.4% vs. 66.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028). While comparing post\u2010PTCB protocol implementation versus pre\u2010implementation, mortality declined from 23.8% to 3.7% with increased discharge rates, although this did not reach statistical significance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.073).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Inclusion of a pediatric otolaryngologist in the resuscitation team reduces time\u2010to\u2010arrival of the pediatric otolaryngologist to the code blue activation site. Reduced time to pediatric otolaryngologist arrival and completion of interventions by pediatric otolaryngologist are associated with reduced mortality in PTCB events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70422","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:57:41Z","timestamp":1770375461000},"page":"2769-2776","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of Pediatric Otolaryngologist in Pediatric Tracheostomy Code Blue Cases: A New Safety Initiative"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2772-2065","authenticated-orcid":false,"given":"Deepa","family":"Shivnani","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head &amp; Neck Surgery University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miles Jonathan","family":"Klimara","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. S.","family":"Shruthi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head &amp; Neck Surgery Mahadevappa Rampure Medical College  Kalaburagi Karnataka India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dnyanesh Balkrishna","family":"Amle","sequence":"additional","affiliation":[{"name":"Department of Biochemistry All India Institute of Medical Sciences (AIIMS)  Nagpur India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9914-9670","authenticated-orcid":false,"given":"Matthew Ern","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery David Geffen School of Medicine at University of California, Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Department of Disease Prevention Stanford University  Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. N.","family":"Ashwath Ram","sequence":"additional","affiliation":[{"name":"Department of Pediatric Intensive Care Unit (PICU), Manipal Hospitals  Bangalore Karnataka India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eswaran Venkat","family":"Raman","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head &amp; Neck Surgery University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gnanam","family":"Aram","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency, Manipal Hospital  Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mallikarjun Ravi","family":"Kobal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Mahadevappa Rampure Medical College  Kalaburagi Karnataka India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2316-0221","authenticated-orcid":false,"given":"Olivia E.","family":"Speed","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010 Head &amp; Neck Surgery University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maie A. St.","family":"John","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery David Geffen School of Medicine at University of California, Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinesh","family":"Chhetri","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery UCLA School of Medicine  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10872981.2022.2106811"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13052\u2010021\u201001058\u20109"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.2.200"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010014\u20103407\u20104"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12625"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972\u20105229.186222"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12839"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0130327"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.113.000691"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022\u20103476(74)80580\u20109"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887\u2010016\u20100593\u2010y"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182746736"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000001307"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000001748"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000315"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e31819a7f90"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/AMEP.S64178"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182a6439d"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2013.07.029"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000541"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215115000158"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2009.094706"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12177"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12994"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X21989722"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.26505"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0300\u20109572(00)00167\u20102"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2006.05.009"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2006.06.007"},{"key":"e_1_2_10_31_1","volume-title":"StatPearls","author":"Vega R. 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