key: cord-0783600-4l1lid9p
authors: Al Shabeeb, Reem Qabas; Lee, Esther; El Shatanofy, Muhammad; Mulcahy, Collin F.; Sherman, Marian L.; Heinz, Eric R.; Yamane, David P.
title: Impact of COVID-19 specific simulation training in improving intubators’ level of comfort during intubations of COVID-19 patients - Results from a USA national survey
date: 2022-01-24
journal: Trends in Anaesthesia and Critical Care
DOI: 10.1016/j.tacc.2022.01.004
sha: 9b2b9d1efc7ed70ac91507805655bc45076246e9
doc_id: 783600
cord_uid: 4l1lid9p

Background Tracheal intubation is a hazardous aerosolizing procedure with a potential risk of spreading SAR-CoV-2 between patients and physicians. Aim The purpose of this study was to explore the impact of COVID-19 specific simulation training in improving provider level of comfort during the intubation of COVID-19 patients. Methods In this cross-sectional national study, an electronic survey was disseminated using a snowball sample approach to intubators from 55 hospitals across the United States. The survey assessed providers’ comfort of intubating and fear of contracting the virus during COVID-19 intubations. Results A total of 329 surveys from 55 hospitals were analyzed. Of 329 providers, 111 providers (33.7%) reported participating in simulation training. Of those, 86 (77.5%) reported that the simulation training helped reduce their fear of intubating COVID-19 patients. Providers in the simulation training group also reported a higher level of comfort level with intubating both general patients (median [range] no-simulation training group 9 [3–10], simulation training group 9 [6–10]; p = 0.015) and COVID-19 patients (no-ST 8 [1–10], ST group 9 [4–10]; p < 0.0005) than providers in the no-simulation training group. Conclusions Our study suggests that COVID-19 specific intubation simulation training promotes provider comfort. Simulation training may be implemented as part of airway management training during the current and novel pandemic situations.

Front line healthcare providers have been combatting the COVID-19 pandemic for over a 49 year and more than 300,000 physicians have contracted the virus worldwide. 1 Simulation training is a commonly used strategy in airway management education and has 58 been found to increase providers comfort in intubation. 8-10 More recently, simulation training has 59 been used to prepare healthcare providers for airway management of COVID-19 patients. 11-15 One 60 study assessing the utility of a simulation training educational intervention in 93 physicians found 61 that simulation training increased providers' comfort in suspected COVID-19 intubations 62 compared to baseline comfort prior to the simulation, a difference of 1.3 points on a 5-point Likert 63 scale (95% confidence interval 1.06 -1.54, p < 0.001). 12 Furthermore, studies have demonstrated 64 that simulation training for nasal swabbing and managing a critically ill patient during the COVID-robust understanding of airway management in patients with COVID-19 in USA hospitals, we 69 created a national survey to assess provider comfort in intubating such patients.

J o u r n a l P r e -p r o o f METHODS Midwest, South, and West. 24 Exposure information included history of positive COVID-19 test, 94 quarantine for potential COVID-19 exposure, being the parent or primary caregiver for a school-95 aged child or infant and/or a person more than 80 years, and having friends/close relatives who 96 have contracted COVID-19. Intubation experience included participation in a dedicated intubation 97 team, education and/or training in donning and doffing personal protective equipment, simulation 98 training, and a negative pressure environment.

In this study, simulation training was broadly defined as participation in exercises like There were no statistical differences in demographic information between the simulation training 148 group and the no-simulation training group. Table 1 lists the demographic characteristics of the 149 participants, and Table 2 lists the geographic characteristics of the participants. The majority of responses from exposure questionnaires in both groups reported no Among the simulation training-group (n=111), 77.5% of providers (n=86) reported a 188 "reduction in fear" after simulation training, 13.5% (n=15) reported "no change in fear", and 9.0% 189 (n=10) reported "not sure". See Table 5 for detailed information. 195 196 In this cross-sectional, survey-based, national study that examined factors affecting 

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