A questionnaire-based cross-sectional pilot survey on adherence to the recognized guidelines by the airway managers during intubation at the time of COVID-19 pandemic

• Main Authors: Debarshi Guha, Deepak Dwivedi, Debashish Paul, Soumya Chakrabarti, Jupi Talukdar, Shalendra Singh
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: The Indian Anaesthetists' Forum
• Subjects: airway management; coronavirus; covid-19 pandemic; endotracheal intubation; infection transmission; personal protective equipment; severe acute respiratory syndrome coronavirus 2
• Online Access: http://www.theiaforum.org/article.asp?issn=2589-7934;year=2021;volume=22;issue=1;spage=40;epage=46;aulast=Guha

Background and Aims: COVID-19 infection has the potential to spread exponentially during aerosol-generating procedures like intubation. The aim was to find the compliance toward the actual practice as well as the existing knowledge gap and adherence to the guidelines among the medical professionals while attempting intubation in a known or suspected COVID-19 patients. Materials and Methods: A cross-sectional web-based survey format was planned using English questionnaire in an online form (Google® Forms). One hundred and forty valid responses for 27 questions were received. Maximum participation was received from Indian anesthesiologists working in government, semi-government, and private health facilities, performing the intubation routinely. All the valid responses were statistically analyzed by calculating the significant difference in means and proportions, with P < 0.05 being considered statistically significant. Results: Eighty percent of the respondents received training for donning and doffing and regularly wore personal protective equipment for the airway procedure. Scarce simulation training (22.1%), minimum screening before entering into a intubation scene (37.9%), frequent use of bag-mask ventilation (18.2%) or high flow nasal cannula (19.7%) use for preoxygenation, confirmation of the depth of endotracheal tube by auscultation (34.5%), and having no plan B in case of unanticipated difficult airway (27.9%) make the knowledge gap evident. The survey pointed out toward the infrastructural requirement of negative pressure intubation rooms, availability of waveform capnography, and widespread use of videolaryngoscope. Conclusion: This survey gives us an insight into the compliance with existing lacunae and nonuniform practices of the recommended guidelines for the airway management during COVID-19 pandemic with its pragmatic solution.