Authors : Bhavna Gupta, Bhavna Gupta, Sukhyanti Kerai, Sukhyanti Kerai, Anish Gupta, Anish Gupta, Lalit Gupta, Lalit Gupta
DOI : 10.18231/j.ijca.2019.065
Volume : 6
Issue : 3
Year : 2019
Page No : 337-342
Introduction: Airway management in critically ill patients in emergency room and periphery wards is an essential component of resuscitation and is considered a high-risk procedure with one or more complications occurring in 22–54% of all intubations performed. As there are few hospitals in India with dedicated emergency physician available, the airway management in emergencies and peripheral wards is done by residents pooled from various specialities. This survey was conducted with objective to assess the challenges encountered during tracheal intubation in emergency settings outside the controlled environment of operation theatre and to know the complications occurring during airway management in these scenarios. Further assessment was conducted with objectives to assess the challenges and dilemma faced by them and to know complications and outcomes associated airway management in these cases.
Materials and Methods: An anonymous 30 questions survey was sent online to 500 doctors from different branches in India as online google forms via email. Data pertaining to respondent demographics, practice characteristics (including availability of resources, medications and equipment’s) were collected and analysed descriptively using different frequencies and percentages and Fisher’s exact tests followed by post hoc multiple comparisons.
Results: 248 residents filled up the questionnaire, 78% were anaesthesiologists, and rest were from different medical branches. Ninety-seven percentage felt the need for display of protocol regarding the guidelines for intubation and cardiopulmonary resuscitation in emergency and periphery locations. All participants felt the need for teaching residents from all specialities to manage peripheral intubation calls.
Conclusions: Airway management at periphery locations is challenging and needs the implementation of algorithms including the new airway devices. Finally, the standard airway guidelines for difficult airway management remain the cornerstone of managing and securing airway at periphery for obvious reasons, although some specific aspects can be adapted in specific scenarios.
Keywords: Difficulties and challenges; Periphery intubation calls, Residents, Need for protocol, Emergency scenario.