Gulamani Amber, Shamim Faisal, Khan Sehrish, Hashmi Sohaib, Abbasi Shemila
Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan.
Department of Emergency Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
Turk J Anaesthesiol Reanim. 2022 Oct;50(5):346-351. doi: 10.5152/TJAR.2021.21104.
The coronavirus disease 2019 (COVID-19) has brought anaesthesiologists, intensive care and emergency physicians to the forefront due to their airway management skills. The aim of survey was to determine current practice trends in COVID-19 airway management among frontline healthcare professionals of Pakistan and their adherence to standard principles proposed by most consensus guidelines.
An online questionnaire was designed based on consensus guidelines from international societies. We contacted consultants and trainees nationwide working in anaesthesia, intensive care, and emergency departments through emails, phone calls, and social media platforms.
A total of 285 individuals participated in this cross-sectional descriptive study. Intubations were largely performed by anaesthetists followed by emergency physicians. Deteriorating respiratory failure (89%) was the most frequent indication. Availability of trained staff, use of intubation checklist, limited staff presence during intubation, and use of appropriate personal protective equipment were positive findings. One-third reported that their workplace did not have negative pressure rooms for aerosol-generating procedures, and 63.3% responders do not perform airway assessment before intubation. The device of choice for the first attempt at laryngoscopy was Macintosh laryngoscope (51.6%) followed by videolaryngoscopes with disposable blades (24.2%). Availability of rescue devices in case of unanticipated difficult airway is variable; laryngeal mask airway (70.1%), bougie (82.2%), and stylet (68.7%) were present at majority places. Frequency of airway-related adverse events including hypoxemia (69.8%) and failed first attempt intubation (35.2%) was significant.
This survey found satisfactory knowledge, comparable practices, and offers some important insights about airway management in COVID-19 patients by healthcare professionals of Pakistan.
2019年冠状病毒病（COVID-19）因气道管理技能，将麻醉医生、重症监护医生和急诊医生推到了前沿。本调查的目的是确定巴基斯坦一线医护人员在COVID-19气道管理方面的当前实践趋势，以及他们对大多数共识指南提出的标准原则的遵守情况。
根据国际协会的共识指南设计了一份在线问卷。我们通过电子邮件、电话和社交媒体平台联系了全国范围内在麻醉科、重症监护室和急诊科工作的顾问和学员。
共有285人参与了这项横断面描述性研究。插管主要由麻醉医生进行，其次是急诊医生。呼吸衰竭恶化（89%）是最常见的指征。训练有素的工作人员的可用性、使用插管检查表、插管期间有限的人员在场以及使用适当的个人防护设备是积极的发现。三分之一的人报告说他们的工作场所没有用于产生气溶胶程序的负压病房，63.3%的受访者在插管前不进行气道评估。首次喉镜检查首选的设备是麦金托什喉镜（51.6%），其次是带一次性刀片的视频喉镜（24.2%）。在意外困难气道情况下救援设备的可用性各不相同；大多数地方都有喉罩气道（70.1%）、探条（82.2%）和管芯（68.7%）。包括低氧血症（69.8%）和首次插管尝试失败（35.2%）在内的气道相关不良事件的发生率很高。
本次调查发现了令人满意的知识、可比的实践，并为巴基斯坦医护人员对COVID-19患者的气道管理提供了一些重要见解。
