Mechanical Ventilation Practices of Turkish Emergency Physicians: A National Survey
Erhan DÜZENLİ, Mustafa SEVER, Ersin AKSAY
Department of Emergency Medicine, Tepecik Training and Research Hospital, Izmir
Keywords: emergency physician, emergency department, resident training, mechanical ventilation, simulation laboratory
Introduction: Our objective is to ascertain the mechanical ventilation management skill perception levels of EPs and infrastructural condition of EDs in respect of mechanical ventilation, in Turkey.
Materials and Methods: In Turkey, a survey aimed at all EPs was conducted. The contents of the survey form were consisted of 4 main titles. Socio-demographic characteristics, situation of the personnel and technical infra-structure in the ED, Emergency Medicine Training Program and post graduate trainings and solution suggestions. Their perception level was evaluated with a 10 cm Visual Analogue Scale.
Results: 400 emergency physicians participated in the study (response rate = 70.5%). The mean of emergency physicians’ perception on whether or not the personnel and technical infrastructure for mechanical ventilation management are adequate, in the institutions where they work was found out to be, respectively, 3.2±2.4 cm and 3.4±2.4 cm. It was determined that %75.5 of the participants had no education on mechanical ventilation management during their emergency medicine education program. The mean value of perception levels on the number of mechanical ventilation practice adequacy during emergency medicine education program was established to be 4.6±2.2 cm and the mean value of perception levels on knowledge and skills about mechanical ventilation management was established to be 5.4±2 cm.
It was determined that, during mechanical ventilation, 29.5% of EPs not used any one of sedative agents and 30.2% of them not used any one of paralyzing agents. It was also determined that, frequently midazolam (30.7%) was used for sedation, fentanyl (50.7%) for analgesia and vecuronium (27%) as neuromuscular blocker.
Conclusion: The skill perception level of emergency physicians on mechanical ventilation management is low. Mechanical ventilation management educations in emergency medicine education programs and infrastructural conditions of emergency departments in respect of mechanical ventilation were both considered as inadequate by emergency physicians.