“STAT No Airway”: Response Pathway for in-hospital airway emergencies in an urban Canadian hospital

Airway emergencies are time-sensitive and can happen at any point, including in hospital. Traditional paging systems may delay access to necessary airway intervention due to ambiguity or delays in activation. In 2024, a Canadian tertiary centre implemented “STAT No Airway”: a multidisciplinary, site-wide airway emergency pathway. Once activated, switchboard staff simultaneously alert anesthesia, general surgery, trauma, otolaryngology, and respiratory therapy through both text and overhead paging with clear, unambiguous terminology about the urgency of the situation. Although pre-response pathway data is unavailable for this site, post-implementation patient outcomes have been highly positive. Ongoing optimizations focus on event tracking, debriefing logistics, and pediatric responses. The STAT No Airway Working Group at the Royal Alexandra Hospital in Edmonton, Alberta, is sharing this pathway for consideration and potential adoption at other tertiary centres. Summary of “STAT No Airway” Response Pathway “STAT No Airway” is a response pathway in an urban, tertiary Canadian hospital for in-hospital use in situations in which the airway is not patent, or situations in which there is not time anticipated for return paging and discussion of airway management prior to in-person response. Simultaneous paging of anesthesia, otolaryngology, general surgery and trauma surgery plans for oral or nasal endotracheal intubation with immediate surgical intervention if oral or nasal intubation is not possible. Simultaneous text and overhead paging using unambiguous language of urgency, “STAT No Airway”, mobilizes providers skilled in airway capture to the response location. This pathway is used in all areas of the hospital and for all ages, optimized through ongoing collaboration between the identified airway specialists as well as switchboard leadership, emergency physicians, respiratory therapists, intensivists and nurses. Even with emergency physician expertise in advanced airway management, the emergency department remains the area with most frequent STAT No Airway activation due to volume and frequency of patients with high-risk airway conditions. Ongoing collaborative work is focused on aligning equipment during response activations, pediatric considerations, tracking of events across the site, and debriefing these critical events for both provider wellness and pathway optimization.