{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:35:48Z","timestamp":1777448148640,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T00:00:00Z","timestamp":1652400000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In 2006, a multi-disciplinary \u201cCode Critical Airway\u201d (CCA) Team was created at our institution. The objective of this study is to examine the demographics and outcomes of the patients for whom a CCA is activated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted of patients for whom a CCA was activated from 2008-2020. Data from 2006-2008 was not available due to timing of the implementation of the hospital\u2019s electronic medical record system. The early period of the experience with CCAs (2008-2014) was compared to the later period (2015-2020) CCA activations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 953 CCA activations. Over time, there was a statistically significantly increase in the number of CCA activations. CCAs occurred in the emergency department in 274 (29.0%), intensive care unit in 255 (27.0%), step-down unit in 60 (6.4%), wards in 294 (31.1%), and elsewhere in 61 (6.5%) cases. CCAs were managed with direct laryngoscopy in 97 patients (10.2%), video laryngoscope in 160 patients (16.8%), fiberoptic bronchoscopy in 179 patients (18.8%), bougie in 7 patient (0.7%), replacement of a prior tracheostomy in 262 patients (27.5%), and creation of a new surgical airway in 95 patients (10.0%). The definitive management of the CCA was not recorded in 76 patients (8.0%). Seven patients required removal of a foreign body (0.7%). There was no intervention in 70 patients (7.3%). There was an increase in successful first attempts at obtaining an airway comparing our experience in the early period (2008-2014) compared to the later period (2015-2020) (P &lt; 0 .001). There was also a decrease in number of CCAs requiring a surgical airway (P = .030).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Inculcation of aggressive early escalation of airway emergencies through implementation of a CCA Team has resulted in significant improvement in first attempt airway stabilization and a decrease in surgical airways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348221101485","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T20:38:36Z","timestamp":1652906316000},"page":"2460-2467","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Code Critical Airway: A Collaborative Solution to a Catastrophic Problem"],"prefix":"10.1177","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7180-5787","authenticated-orcid":false,"given":"Amber","family":"Himmler","sequence":"first","affiliation":[{"name":"MedStar Georgetown University Hospital-Washington Hospital Center Residency Program in General Surgery, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea","family":"Mcdermott","sequence":"additional","affiliation":[{"name":"MedStar Georgetown University Hospital-Washington Hospital Center Residency Program in General Surgery, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Martucci","sequence":"additional","affiliation":[{"name":"Georgetown School of Medicine, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Rhoades","sequence":"additional","affiliation":[{"name":"Department of Surgical Critical Care, MedStar Washington Hospital Center, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine T.","family":"Trankiem","sequence":"additional","affiliation":[{"name":"Division of Trauma, MedStar Washington Hospital Center, Washington, DC, USA"},{"name":"Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6969-2648","authenticated-orcid":false,"given":"Laura S.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Trauma, MedStar Washington Hospital Center, Washington, DC, USA"},{"name":"Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA"},{"name":"The Burn Center, MedStar Washington Hospital Center, Washington, DC, 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