Factors affecting providers' comfort and fear during intubations of patients with COVID-19

Authors

Esther Lee, Western University of Health Sciences, Pomona, California, USA esther.lee1@westernu.edu.
Reem Qabas Al Shabeeb, Internal Medicine, Inova Fairfax Hospital, Falls Church, Virginia, USA.
Muhammad El Shatanofy, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Collin F. Mulcahy, Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
David P. Yamane, Department of Anesthesiology and Critical Care, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Marian L. Sherman, Department of Anesthesiology and Critical Care, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Eric R. Heinz, Department of Anesthesiology and Critical Care, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Document Type

Journal Article

Publication Date

11-3-2022

Journal

Emergency medicine journal : EMJ

DOI

10.1136/emermed-2021-212052

Abstract

BACKGROUND: Providers performing endotracheal intubation are at high risk of contracting SARS-CoV-2. The objective was to assess various demographic, exposure and institutional preparedness factors affecting intubators' comfort and fear level during COVID-19 intubations. METHODS: We conducted a cross-sectional, survey-based study during the COVID-19 pandemic from September 2020 to January 2021 at a single academic medical centre in Washington, DC, USA. Inclusion criteria were healthcare providers who had an experience in intubating patients confirmed with or suspected of COVID-19. The survey assessed various factors related to the providers' comfort with intubation and fear during COVID-19 intubations. RESULTS: A total of 329 surveys from 55 hospitals were analysed. Of the respondents, 173 (52.6%) were from emergency medicine providers. Factors that were associated with a higher comfort level of intubating patients with COVID-19 included attending physician position (adjusted OR (aOR)=2.6, 95% CI 1.4 to 4.8; p=0.003), performing more than 20 COVID-19 intubations (aOR=3.3, 95% CI 1.5 to 6.6; p=0.002), participation in an intubation team (aOR=1.6, 95% CI 1.1 to 2.7; p=0.031) and adequate levels of personal protective equipment (PPE) (aOR=4.3, 95% CI 2.0 to 8.8; p<0.0005). Compared with emergency physicians, anaesthesiology providers had higher fear levels of contracting SARS-CoV-2 during both first and subsequent SARS-CoV-2 intubations (first: OR=1.7, 95% CI 1.1 to 2.6, p=0.006; subsequent: OR=2.0, 95% CI 1.4 to3.2, p<0.0005). CONCLUSION: A higher degree of comfort in intubating patients suspected of or confirmed with COVID-19 was demonstrated in more senior physicians, members of intubation teams, providers who performed a higher number of intubations and providers who reported adequate PPE. These findings highlight potential targets for improving the experience of providers in this setting.

APA Citation

Lee, Esther; Al Shabeeb, Reem Qabas; El Shatanofy, Muhammad; Mulcahy, Collin F.; Yamane, David P.; Sherman, Marian L.; and Heinz, Eric R., "Factors affecting providers' comfort and fear during intubations of patients with COVID-19" (2022). GW Authored Works. Paper 1977.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1977

Department

Emergency Medicine