Airway management during in-hospital cardiac arrest in adults: UK national survey and interview study with anaesthetic and intensive care trainees.
Goodwin, Laura Samuel, Katie Schofield, Behnaz Voss, Sarah Brett, Stephen J Couper, Keith Gould, Doug Harrison, David Lall, Ranjit Nolan, Jerry P
Goodwin, Laura
Samuel, Katie
Schofield, Behnaz
Voss, Sarah
Brett, Stephen J
Couper, Keith
Gould, Doug
Harrison, David
Lall, Ranjit
Nolan, Jerry P
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2020-08-18
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Abstract
Background: The optimal airway management strategy for in-hospital cardiac arrest is unknown.
Methods: An online survey and telephone interviews with anaesthetic and intensive care trainee doctors identified by the United Kingdom Research and Audit Federation of Trainees. Questions explored in-hospital cardiac arrest frequency, grade and specialty of those attending, proportion of patients receiving advanced airway management, airway strategies immediately available, and views on a randomised trial of airway management strategies during in-hospital cardiac arrest.
Results: Completed surveys were received from 128 hospital sites (76% response rate). Adult in-hospital cardiac arrests were attended by anaesthesia staff at 40 sites (31%), intensive care staff at 37 sites (29%) and a combination of specialties at 51 sites (40%). The majority (123/128, 96%) of respondents reported immediate access to both tracheal intubation and supraglottic airways. A bag-mask technique was used 'very frequently' or 'frequently' during in-hospital cardiac arrest by 111/128 (87%) of respondents, followed by supraglottic airways (101/128, 79%) and tracheal intubation (69/128, 54%). The majority (60/100, 60%) of respondents estimated that ≤30% of in-hospital cardiac arrest patients undergo tracheal intubation, while 34 (34%) estimated this to be between 31% and 70%. Most respondents (102/128, 80%) would be 'likely' or 'very likely' to recruit future patients to a trial of alternative airway management strategies during in-hospital cardiac arrest. Interview data identified several barriers and facilitators to conducting research on airway management in in-hospital cardiac arrest.
Conclusions: There is variation in airway management strategies for adult in-hospital cardiac arrest across the UK. Most respondents would be willing to take part in a randomised trial of airway management during in-hospital cardiac arrest.
Citation
Goodwin L, Samuel K, Schofield B, Voss S, Brett SJ, Couper K, Gould D, Harrison D, Lall R, Nolan JP, Perkins GD, Soar J, Thomas M, Benger J; Research and Audit Federation of Trainees (RAFT) network. Airway management during in-hospital cardiac arrest in adults: UK national survey and interview study with anaesthetic and intensive care trainees. J Intensive Care Soc. 2021 Aug;22(3):192-197. doi: 10.1177/1751143720949458. Epub 2020 Aug 18. Erratum in: J Intensive Care Soc. 2022 Nov;23(4):518
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Article