Author: IT Services

Randomisation Form—PWA

Site and clinician details (set at log in):

Site Name : ___________________________________
Clinician ID: ___________________________________
.

d

d

m

o

n

y

y

y

y

1. DATE AND TIME OF RANDOMISATION:

1.1 Day or Night (Select ONE for stratification) :
Day (08:00—20:00)
Night (20:01—07:59)
1.2 Date of randomisation (set by device date):
1.3 Time of randomisation (set by device time):
.

d

d

m

o

n

y

y

y

y

d

d

m

o

n

y

y

y

y

h

h

:

m

m

Participant Identification Number (generated by PWA):

Supraglottic airway device
Tracheal intubation

Treatment Allocation (generated by PWA):

AIRWAYS-3 Form number: 1