Emergency intubation outside operating room/intensive care unit settings: Are we following the recommendations for safe practice?

Abstract

CONTEXT: Although international guidelines have been developed for emergency tracheal intubation (ETI), there is little evidence of their applicability in developing countries. AIMS: The aim of this study was done to evaluate the different methods of ETI that are practiced among anesthetist and anesthesia trainees in India outside operating room (OR)/intensive care unit (ICU) settings. SETTINGS AND DESIGN: This was prospective observational audit did among anesthesia personals managing ETI outside OR and ICU. MATERIALS AND METHODS: The study was conducted through an online survey using electronic media. Certified anesthetists and anesthesia trainees were sent a questionnaire where they were asked to complete and submit it online. RESULTS: Out of 145 respondents, 52% were certified anesthetists. Availability of equipment, technical staff, and visual monitors was a big constraint. About 28% of the participants do not examine the airway before ETI, 61% of participants invariably do not perform rapid sequence induction and intubation, and 89% of the participants have only the bougie at their disposal with the availability of videolaryngoscope (10%) and Fibreoptic bronchoscopy (FOB) (6%) being scarce. About 12% of the respondents use capnography for ETI confirmation. Only 48% of the participants accompany the patient during shifting. CONCLUSIONS: Our survey has reported wide disparity during ETI with poor compliance to the international guidelines.