Journal article
Role of Pediatric Otolaryngologist in Pediatric Tracheostomy Code Blue Cases: A New Safety Initiative
The Laryngoscope, 8607378
02/06/2026
DOI: 10.1002/lary.70422
PMID: 41646023
Appears in UI Libraries Support Open Access
Abstract
Objective A "Code Blue" 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-related code blue case is not clearly defined. We aim to describe the role of pediatric otolaryngologists in pediatric tracheostomy code blue (PTCB) cases. Methods 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-to-discharge of patients. Results 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 min pre-implementation to 4.0 min post-implementation (p < 0.001). While including all 48 PTCB events, pediatric otolaryngologist involvement was significantly associated with higher survival-to-discharge (94.4% vs. 66.7%, p = 0.028). While comparing post-PTCB protocol implementation versus pre-implementation, mortality declined from 23.8% to 3.7% with increased discharge rates, although this did not reach statistical significance (p = 0.073). Conclusion Inclusion of a pediatric otolaryngologist in the resuscitation team reduces time-to-arrival 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. Level of Evidence 3.
Details
- Title: Subtitle
- Role of Pediatric Otolaryngologist in Pediatric Tracheostomy Code Blue Cases: A New Safety Initiative
- Creators
- Deepa Shivnani - University of IowaMiles Jonathan Klimara - University of IowaM. S. Shruthi - ESIC HospitalDnyanesh Balkrishna Amle - All India Institute of Medical Sciences JodhpurMatthew Ern Lin - University of California, Los AngelesIan Kim - Palo Alto Center for Pulmonary Disease PreventionR. N. Ashwath Ram - Manipal Hosp, Dept Pediat, Intens Care Unit PICU, Bangalore, Karnataka, IndiaEswaran Venkat Raman - University of IowaGnanam Aram - Manipal HospitalMallikarjun Ravi Kobal - SVS Medical CollegeOlivia E. Speed - University of Arkansas for Medical SciencesMaie A. St John - Univ Calif Los Angeles, Dept Head & Neck Surg, David Geffen Sch Med, Los Angeles, CA USADinesh Chhetri - UCLA, Sch Med, Dept Head & Neck Surg, Los Angeles, CA USA
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, 8607378
- DOI
- 10.1002/lary.70422
- PMID
- 41646023
- ISSN
- 0023-852X
- eISSN
- 1531-4995
- Publisher
- Wiley
- Number of pages
- 8
- Language
- English
- Date published
- 02/06/2026
- Academic Unit
- Otolaryngology
- Record Identifier
- 9985156728102771
Metrics
1 Record Views