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Airway management during in-hospital cardiac arrest in adults : UK national survey and interview study with anaesthetic and intensive care trainees

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Goodwin, Laura, Samuel, Katie, Schofield, Behnaz, Voss, Sarah, Brett, Stephen J., Couper, Keith, Gould, Doug, Harrison, David, Lall, Ranjit, Nolan, Jerry P., Perkins, Gavin D., Soar, Jasmeet, Thomas, Matthew and Benger, Jonathan (2020) Airway management during in-hospital cardiac arrest in adults : UK national survey and interview study with anaesthetic and intensive care trainees. Journal of the Intensive Care Society . 175114372094945. doi:10.1177/1751143720949458 (In Press)

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Official URL: https://doi.org/10.1177/1751143720949458

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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.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
R Medicine > RF Otorhinolaryngology
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Airway (Medicine), Cardiac arrest , Cardiac arrest -- Treatment, Respiratory therapy, Trachea -- Intubation
Journal or Publication Title: Journal of the Intensive Care Society
Publisher: SAGE Publications
ISSN: 1751-1437
Official Date: 18 August 2020
Dates:
DateEvent
18 August 2020Published
18 August 2020Accepted
Date of first compliant deposit: 2 September 2020
Article Number: 175114372094945
DOI: 10.1177/1751143720949458
Status: Peer Reviewed
Publication Status: In Press
Publisher Statement: Goodwin L, Samuel K, Schofield B, et al. Airway management during in-hospital cardiac arrest in adults: UK national survey and interview study with anaesthetic and intensive care trainees. Journal of the Intensive Care Society. August 2020. doi:10.1177/1751143720949458. Copyright © 2020 by [The Authors]. Reprinted by permission of SAGE Publications. DOI: https://doi.org/10.1177/1751143720949458.
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
RCF-SI-2019-01University Hospitals Bristol NHS Foundation Trusthttp://dx.doi.org/10.13039/100012141
UNSPECIFIED[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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