Key result
Intensive care specialists reported varying confidence in airway management, with clinical experience, anaesthetic qualifications, and training identified as major facilitators.
Why the study?
To explore self-confidence, along with facilitators and barriers, among intensive care specialists in Australia and New Zealand regarding airway management.
Cross-Sectional (n=48)
Yes
Confidence in airway management among intensive care specialists varies by clinical context, highlighting the need for additional mandatory training and resources like video-laryngoscopy.
ICU specialists report lower confidence in advanced airways; cross-sectional data leaves open whether targeted training improves competence or safety.
Objective: To explore self-confidence, and the respective facilitators and barriers, among intensive care specialists in Australia and New Zealand in relation to airway management . Design: A mixed methods study. Setting: 11 intensive care units across Australia and New Zealand. Participants: 48 intensive care specialists. Intervention: A structured online interview and the presentation of three discrete airway management clinical scenarios — routine endotracheal intubation , awake fibreoptic intubation (AFOI), and emergency front of neck access (FONA). Main outcome measures: Graded Likert scale responses regarding confidence in airway management were analysed, and perceptions of facilitators and barriers to confidence in each select scenario were obtained as free text. A deductive thematic analysis was done iteratively on free text entry and allowed for the development of a coding framework. NVivo software used the coding framework to run coding queries and cross-tabulations for comparison of relationships between themes and participant demographic characteristics. Results: Participants reported differing levels of confidence. Clinical experience, an anaesthetic qualification and training (including simulation) were the major facilitators to influencing confidence. Participants were more confident performing routine intubation than AFOI or FONA. Equipment, checklists or protocols, and availability of video-laryngoscopy were also identified as facilitators to confidence by most participants. Work relationships, teams and other staff availability were identified as further facilitators to confidence; lack of these factors were less commonly identified as barriers. Conclusions: Confidence in airway management among intensive care specialists in Australia and New Zealand varies, both between specialists and depending on clinical context. Multiple facilitators to improving this exist, including additional mandatory training.
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Shahab et al. (2022) conducted a cross-sectional in Airway management proficiency (n=48). Structured online interview and clinical scenarios was evaluated on Confidence in airway management and perceptions of facilitators and barriers. Intensive care specialists reported varying confidence in airway management, with clinical experience, anaesthetic qualifications, and training identified as major facilitators.
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