Skip to main content
Top
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 2/2022

01-02-2022 | COVID-19 | Reports of Original Investigations

Performance and impact of an airway management team launched during the COVID-19 pandemic

Authors: Keziah Magor, BSc, Tejinder Chhina, MD, FRCPC, Ivan Cacic, MD, FRCPC, Bill I. Wong, MD, FRCPC, Hossam El Beheiry, MBBCh, PhD, FRCPC

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 2/2022

Login to get access

Abstract

Purpose

To determine the performance and impact of an airway management team (AMT) assembled during the COVID-19 pandemic.

Methods

We conducted a retrospective cohort review of all adult patients who had received airway management services from the AMT (n = 269) and administered a survey questionnaire targeting physicians who had the option to activate the AMT (n = 77). The retrospective review determined the performance of the AMT, and the physicians’ survey evaluated the impact of the AMT. The study was conducted at a large Canadian health centre (1,133 beds) from 28 March to 30 June 2020. We included patients in the cohort review who were ≥18 yr of age, whose chart showed that the AMT was activated, and whose airway was managed outside the operating room. We reviewed both electronic medical records and paper chart documentation. Outcomes included intubation success, number of intubation attempts, intubation time, team response time, patient contact time, intubation complications, and breaches of personal protective equipment (PPE) protocol. The physicians’ survey evaluated the relevance, performance, reasonableness, and clinical utility of the AMT.

Results

The AMT intubated 231 patients. Charts showed that 91% of intubations were accomplished on first attempt. The mean (standard deviation) intubation time was 2.1 (0.2) min. The complication rate was minimal. The incidence of breaching PPE protocol items was less than 6%. No AMT members reported COVID-19 symptoms. The response rate for the physician’s survey was 36%. The consensus among the participants was that the AMT had considerable clinical utility during the COVID-19 pandemic.

Conclusion

An AMT assembled during the COVID-19 pandemic showed high competency and effectiveness, and had favourable impact on the main responsible physicians who activated the team.
Appendix
Available only for authorised users
Literature
1.
go back to reference Marchand-Senécal X, Kozak R, Mubareka S, et al. Diagnosis and Management of First Case of COVID-19 in Canada: Lessons applied from SARS. Clinical Infectious Diseases 2020; 16: 2207–10.CrossRef Marchand-Senécal X, Kozak R, Mubareka S, et al. Diagnosis and Management of First Case of COVID-19 in Canada: Lessons applied from SARS. Clinical Infectious Diseases 2020; 16: 2207–10.CrossRef
3.
go back to reference Yang X, Yu Y, Xu J,et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8: 475-81. Erratum: Lancet Respir Med 2020; 8: e26. Yang X, Yu Y, Xu J,et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8: 475-81. Erratum: Lancet Respir Med 2020; 8: e26.
4.
go back to reference Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020; 323: 1574-81. Erratum in: JAMA 2021; 325: 2120. Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020; 323: 1574-81. Erratum in: JAMA 2021; 325: 2120.
5.
go back to reference Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. medRxiv [Preprint]. 2020 Apr 20:2020.04.15.20067157. DOI: https://doi.org/10.1101/2020.04.15.20067157. Update in: Lancet 2020; 6;395(10239): 1763-70. Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. medRxiv [Preprint]. 2020 Apr 20:2020.04.15.20067157. DOI: https://​doi.​org/​10.​1101/​2020.​04.​15.​20067157. Update in: Lancet 2020; 6;395(10239): 1763-70.
8.
go back to reference Sorbello M, El-Boghdadly K, Di Giacinto I, et al. The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice. Anaesthesia 2020; 75: 724-32.CrossRef Sorbello M, El-Boghdadly K, Di Giacinto I, et al. The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice. Anaesthesia 2020; 75: 724-32.CrossRef
10.
go back to reference Yang M, Dong H, Lu Z. Role of anaesthesiologists during the COVID-19 outbreak in China. Br J Anaesth 2020; 124: 666-9.CrossRef Yang M, Dong H, Lu Z. Role of anaesthesiologists during the COVID-19 outbreak in China. Br J Anaesth 2020; 124: 666-9.CrossRef
11.
go back to reference Smith TG, Ahmad I, Takhar A, et al. Unconventional multidisciplinary team strategy for tracheostomy in COVID-19. Anaesth Rep 2020; 8: 178-82.CrossRef Smith TG, Ahmad I, Takhar A, et al. Unconventional multidisciplinary team strategy for tracheostomy in COVID-19. Anaesth Rep 2020; 8: 178-82.CrossRef
12.
go back to reference Ahmad I, Jeyarajah J, Nair G, et al. A prospective, observational, cohort study of airway management of patients with COVID-19 by specialist tracheal intubation teams. Can J Anesth 2021; 68: 196-203.CrossRef Ahmad I, Jeyarajah J, Nair G, et al. A prospective, observational, cohort study of airway management of patients with COVID-19 by specialist tracheal intubation teams. Can J Anesth 2021; 68: 196-203.CrossRef
13.
go back to reference Yao W, Wang T, Jiang B, et al. Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations. Br J Anaesth 2020; 125: e28-37.CrossRef Yao W, Wang T, Jiang B, et al. Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations. Br J Anaesth 2020; 125: e28-37.CrossRef
16.
go back to reference McLean SA, Paxton SJ, Massey R, e al. Pre-notification but not envelope teaser increased response rates in a bulimia nervosa mental health literacy survey: a randomized controlled trial. J Clin Epidemiol 2014; 67: 870-6. McLean SA, Paxton SJ, Massey R, e al. Pre-notification but not envelope teaser increased response rates in a bulimia nervosa mental health literacy survey: a randomized controlled trial. J Clin Epidemiol 2014; 67: 870-6.
Metadata
Title
Performance and impact of an airway management team launched during the COVID-19 pandemic
Authors
Keziah Magor, BSc
Tejinder Chhina, MD, FRCPC
Ivan Cacic, MD, FRCPC
Bill I. Wong, MD, FRCPC
Hossam El Beheiry, MBBCh, PhD, FRCPC
Publication date
01-02-2022
Publisher
Springer International Publishing
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 2/2022
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-021-02144-6

Other articles of this Issue 2/2022

Canadian Journal of Anesthesia/Journal canadien d'anesthésie 2/2022 Go to the issue