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.