Cortese Gerardo, Sorbello Massimiliano, Di Giacinto Ida, Cedrone Martina, Urdaneta Felipe, Brazzi Luca
Department of Anaesthesia, Intensive Care and Emergency, AOU Città della Salute e della Scienza, Corso Dogliotti 14, 10126 Turin, Italy.
Anesthesia and Intensive Care, AOU Policlinico San Marco, 95121 Catania, Italy.
J Clin Med. 2022 Jul 22;11(15):4271. doi: 10.3390/jcm11154271.
The SARS-CoV-2 pandemic heavily impacted healthcare workers, increasing their physical and psychological workload. Specifically, COVID-19 patients' airway management is definitely a challenging task regarding both severe and acute respiratory failure and the risk of contagion while performing aerosol-generating procedures. The category of anesthesiologists and intensivists, the main actors of airway management, showed a poor psychological well-being and a high stress and burnout risk. Identifying and better defining the specific main SARS-CoV-2-related stressors can help them deal with and effectively plan a strategy to manage these patients in a more confident and safer way. In this review, we therefore try to analyze the relevance of human factors and non-technical skills when approaching COVID-19 patients. Lessons from the past, such as National Audit Project 4 recommendations, have taught us that safe airway management should be based on preoperative assessment, the planning of an adequate strategy, the optimization of setting and resources and the rigorous evaluation of the scenario. Despite, or thanks to, the critical issues and difficulties, the "take home lesson" that we can translate from SARS-CoV-2 to every airway management is that there can be no more room for improvisation and that creating teamwork must become a priority.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行对医护人员产生了重大影响，增加了他们的身体和心理负担。具体而言，对于新型冠状病毒肺炎（COVID-19）患者的气道管理，无论是在严重和急性呼吸衰竭方面，还是在进行产生气溶胶的操作时的传染风险方面，无疑都是一项具有挑战性的任务。气道管理的主要参与者麻醉医生和重症医学专家表现出较差的心理健康状况以及较高的压力和职业倦怠风险。识别并更好地界定与SARS-CoV-2相关的具体主要应激源，有助于他们以更自信、更安全的方式应对并有效制定管理这些患者的策略。因此，在本综述中，我们试图分析在诊治COVID-19患者时人为因素和非技术技能的相关性。过去的经验教训，如国家审计项目4的建议，告诉我们安全的气道管理应基于术前评估、制定适当的策略、优化环境和资源以及对情况进行严格评估。尽管存在这些关键问题和困难，或者说正因为这些问题和困难，我们可以从SARS-CoV-2中汲取并应用于每一次气道管理的“经验教训”是，不能再有即兴发挥的空间，建立团队合作必须成为优先事项。
