Improvement in intubation success during COVID-19 pandemic with a simple and low-cost intervention: A quasi-experimental study

OBJECTIVES

primary objective: to improve the FPS rates after an educational intervention.

SECONDARY OBJECTIVE

to describe variables related to FPS in an ED and determine which ones were related to the highest number of attempts.

DESIGN

it was a prospective quasi-experimental study.

SETTING

done in an ED in a public Hospital in Argentina.

PATIENTS

there were patients of all ages with intubation in ED.

INTERVENTIONS

in the middle of the study, an educational intervention was done to improve FPS. Cognitive aids and pre- intubation Checklists were implemented.

MAIN VARIABLES OF INTEREST

the operator experience, the number of intubation attempts, intubation judgment, predictors of a difficult airway, Cormack score, assist devices, complications, blood pressure, heart rate, and pulse oximetry before and after intubation All the intubations were done by direct laryngoscopy (DL).

RESULTS

data from 266 patients were included of which 123 belonged to the basal period and 143 belonged to the post-intervention period. FPS percentage of the pre-intervention group was 69.9% (IC95%: 60.89-77.68) whereas the post-intervention group was 85.3% (IC95%: 78.20-90.48). The difference between these groups was statistically significant (p=0.002). Factors related to the highest number of attempts were low operator experience, Cormack-Lehane 3 score and no training.

CONCLUSIONS

a low-cost and simple educational intervention in airway management was significantly associated with improvement in FPS, reaching the same rate of FPS than in high income countries.