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Indian Journal of Anesthesia and Analgesia

Volume  7, Issue 6, November-December 2020, Pages 1273-1276
 

Original Article

A Survey of Intubation of COVID-19 Patients in the Critical Care Units to Assess Adherence to Guidelines and Critical Events Encountered

Akhya kumar kar1, Ayya Syama Sundar2

1Assistant Professor, 2Associate Professor, Department of Anesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7620.56

Abstract

Background: The Coronavirus disease (COVID-19) pandemic affected the health care personnel with the worse outcome as compared to the general population.Anaesthesiologists,being the first responders in critical care units (ICU) for aerosol-generating procedures like endotracheal intubation are at higher risk of getting infected with the virus.The updated SARS guideline (Severe Acute Respiratory Syndrome) of the 2003 epidemic in Toronto, Canada, is quite instructive for endotracheal intubation. This study was intended with the primary objective to find out the adherence of guidelines among the anaesthesiologists while doing endotracheal intubation and the secondary objective is to assess the incidence of other critical events.

Methods: This survey was conducted in a tertiary care centre among the anaesthesiologists about their first COVID-19 patient intubation,based on a 40-point questionnaire about adherence of guidelines and critical event encountered. All the responses collected in google form which was further evaluated with the help of SPSS-17.

Results: Total of 112 patients intubated in the ICU, out of which 62% were emergency intubation, aerosol boxes used while intubation in 20% cases. Hand hygiene before the procedure was not followed in 25% and no gowns used while doing the procedure was recorded in 34% respondents. Clamping ET tube and use of hydrophobic filter was missed in 15% and 22% cases. The surroundings contaminated in 51% of respondents. Hypoxia, hypotension, arrhythmia, hypertension, cardiac arrest and aspiration during intubation was observed in 58%, 62%, 29%, 21%, 22%, 11% cases respectively.

Conclusion: With the anaesthesiologists getting adapted to the new norms of intubation in COVID days, the adherence to guidelines is suboptimal, and the complication rate was high during the first intubation attempts.

 


Keywords : Intubation; Survey; SARS Coronavirus.
Corresponding Author : Ayya Syama Sundar