B62-02 Increasing First Responder Confidence During Pediatric Tracheostomy Emergencies Using the Tracheostomy Emergency and Airway Management Card

Abstract Rationale Children with tracheostomies have unique airway risks requiring swift assessment and intervention. While first responders frequently receive training to provide appropriate care during emergencies, limited exposure to real-world pediatric tracheostomy emergencies makes identifying the necessary interventions challenging. The Tracheostomy Emergency Airway Management (TEAM) Card, a self-guided reference tool developed by Children’s Wisconsin Tracheostomy and Home Ventilator program, has previously shown improved caregiver confidence during airway emergencies. This quality improvement (QI) initiative assessed its impact on first responders. Methods Through QI methodology, the TEAM Card was created and distributed to patients starting in August 2024, with green cards for patients intubatable from above and red for those not intubatable. In September 2025, a local emergency medical services (EMS) group completed an in-person pediatric tracheostomy training course that included a pre-course online module followed by a hands-on demonstration and equipment practice. Our team assisted with instruction during a 60-minute group session. Both components covered emergency tracheostomy care and introduced the TEAM Card’s content and use. Following the demonstration, surveys were distributed to the EMS group. Survey questions included both quantitative measurements on their comfort level providing airway emergency care and qualitative measurements of their comfort level using the TEAM Card. Quantitative measurements were compared using a two-tailed T-test. Results Forty-two surveys were distributed, and 39 surveys were used for analysis. Most participants had 1 year of experience or less (n = 19, 53%) and had not provided emergency tracheostomy care within the last year (n = 22, 56%). First responders expressed significantly increased confidence in airway emergency care using the TEAM Card (Table 1, p-value 0.0001, 95% CI 2.32 - 3.90). Only one participant indicated decreased confidence. Confidence improved equally amongst all participants, with no difference seen between experienced and inexperienced first responders. Most found the card easy to read, navigate, and use, and 86% reported they would use it during an emergency. Conclusion The TEAM Card increases first responder confidence across all levels of experience in managing pediatric tracheostomy airway emergencies, supporting its broader implementation in emergency care. Low cost and integration into existing training modules support scalable adoption into different tracheostomy & home ventilator programs. Future work will evaluate real-world EMS use, potential impact on patient outcomes, and explore dissemination across regional EMS systems. This abstract is funded by: None