Orotracheal intubation: physicians knowledge assessment and clinical practices in intensive care units

To assess the physician’s knowledge on intubation techniques and to identify the common practices.

This was a prospective study, involving three different intensive care units within a University hospital: Anesthesiology (ANEST), Pulmonology (PULMO) and Emergency Department (ED). All physicians working in these units and consenting to participate in the study completed a questionnaire with their demographic data and questions on orotracheal intubation.

85 completed questionnaires were retrieved (90.42% of the physicians). ANEST had the higher mean age (p=0.001), being 43.5% of them intensivists. The use of hypnotic and opioid association was reported by 97.6%, and pre-oxygenation by 91.8%, but only 44.6% reported sub-occipital pad use, with no difference between the ICUs. On ANEST an increased neuromuscular blockade use was reported (p<0.000) as well as increased caution with full stomach (p=0.002). The rapid sequence knowledge was restricted (mean 2.20 ± 0.89), p=0.06 between the different units. The Sellick maneuver was known by 97.6%, but 72% used it inappropriately.

Physicians knowledge on orotracheal intubation in the intensive care unit is unsatisfactory, even among qualified professionals. It is necessary to check if the responses to the questionnaire and actual clinical practices agree.