Rapid sequence intubation: a survey of current practice in the South African pre-hospital setting

Autor:	Andrit Lourens, Johanna Catharina Botha, Willem Stassen
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Clinical governance medicine.medical_specialty Rapid sequence intubation (RSI) Pre-hospital Minimum standards Education and training System requirements Comprehensive clinical governance South Africa Scope of practice business.industry Hospital setting RC86-88.9 medicine.medical_treatment media_common.quotation_subject Medical emergencies. Critical care. Intensive care. First aid Snowball sampling Current practice Family medicine Internship Emergency Medicine medicine Intubation Quality (business) business Original Research media_common
Zdroj:	International Journal of Emergency Medicine, Vol 14, Iss 1, Pp 1-11 (2021) International Journal of Emergency Medicine
ISSN:	1865-1380 1865-1372
Popis:	Background Rapid sequence intubation (RSI) is an advanced airway skill commonly performed in the pre-hospital setting globally. In South Africa, pre-hospital RSI was first approved for non-physician providers by the Health Professions Council of South Africa in 2009 and introduced as part of the scope of practice of degree qualified Emergency Care Practitioners (ECPs) only. The research study aimed to investigate and describe, based on the components of the minimum standards of pre-hospital RSI in South Africa, specific areas of interest related to current pre-hospital RSI practice. Methods An online descriptive cross-sectional survey was conducted amongst operational ECPs in the pre-hospital setting of South Africa, using convenience and snowball sampling strategies. Results A total of 87 participants agreed to partake. Eleven (12.6%) incomplete survey responses were excluded while 76 (87.4%) were included in the data analysis. The survey response rate could not be calculated. Most participants were operational in Gauteng (n = 27, 35.5%) and the Western Cape (n = 25, 32.9%). Overall participants reported that their education and training were perceived as being of good quality. The majority of participants (n = 69, 90.8%) did not participate in an internship programme before commencing duties as an independent practitioner. Most RSI and post-intubation equipment were reported to be available; however, our results found that introducer stylets and/or bougies and end-tidal carbon dioxide devices are not available to some participants. Only 50 (65.8%) participants reported the existence of a clinical governance system within their organisation. Furthermore, our results indicate a lack of clinical feedback, deficiency of an RSI database, infrequent clinical review meetings and a shortage of formal consultation frameworks. Conclusion The practice of safe and effective pre-hospital RSI, performed by non-physician providers or ECPs, relies on comprehensive implementation and adherence to all the components of the minimum standards. Although there is largely an apparent alignment with the minimum standards, recurrent revision of practice needs to occur to ensure alignment with recommendations. Additionally, some areas may benefit from further research to improve current practice.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::10f8a211d096cebe3107c2b295b53141 https://doaj.org/article/f32ea22016f744109d24f56c371c359b Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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