AB139. SOH26AB_0045. WETFLAG in anaesthesia: a quality improvement project (QIP) for paediatric patient safety in Health Service Executive (HSE) Mid-West
Anaesthesia Session

AB139. SOH26AB_0045. WETFLAG in anaesthesia: a quality improvement project (QIP) for paediatric patient safety in Health Service Executive (HSE) Mid-West

Saira Asghar1, Wan Nur Jasmine binti Aziz Zabidi2, Shane Moore1, Peter O’Connor1, Dominic Harmon1

1Department of Anaesthesia, University Hospital Limerick, Limerick, Ireland; 2Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland

Background: “WETFLAG” (weight, energy, tube, fluid, lorazepam, adrenaline intravenous, glucose) is an acronym developed by advanced paediatric life support (APLS) to estimate weight-based doses for cardiac arrest, endotracheal tube size, hypovolemia, seizures, and hypoglycaemia. Our quality improvement project (QIP) aimed to evaluate and improve the current level of knowledge and familiarity of anaesthesiologists regarding WETFLAG and its application according to the APLS update 2023, as well as their basic understanding of handling these emergencies with WETFLAG.

Methods: Anaesthesiologists were surveyed before and after teaching and practice sessions, and APLS aide memoire and WETFLAG posters were pasted in operation theatres of University Hospital Limerick, Croom Hospital, Nenagh Hospital, and Ennis Hospital from 28-06-2025 to 10-11-2025 to write weight-based WETFLAG for each paediatric patient on the list. As relevant to anaesthesia, suxamethonium (intravenous and intramuscular) and atropine doses were added for intraoperative management of laryngospasm and bradycardia, respectively (WETFLAG-SA).

Results: Pre-teaching survey results indicated 67.29% response rate. Knowledge and familiarity with WETFLAG and its application were accurately increased from 90.32% to 100% and 64.52% to 100%, respectively, post-teaching. Awareness regarding the recent APLS update for WETFLAG and basic understanding of handling paediatric emergencies were also increased from 64.52% to 96.3%. In total, 61.29% of respondents had no paediatric life support (PLS) certifications. Approximately 19.35% had APLS and PLS certifications each. In total, 100% respondents agreed that WETFLAG is a useful clinical and teaching tool.

Conclusions: Our QIP improved paediatric patient safety in anaesthesia with the application of a simple acronym WETFLAG by APLS to prepare for paediatric emergencies.

Keywords: Advanced paediatric life support (APLS); anaesthesia; awareness; paediatric emergencies; paediatric patient safety

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab139
Cite this abstract as: Asghar S, Zabidi WNJBA, Moore S, O’Connor P, Harmon D. AB139. SOH26AB_0045. WETFLAG in anaesthesia: a quality improvement project (QIP) for paediatric patient safety in Health Service Executive (HSE) Mid-West. Mesentery Peritoneum 2026;10:AB139.

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