Knowledge and Confidence Level Among Emergency Healthcare Workers in Airway Management and Resuscitation of Suspected COVID-19 Patients: A Cross Sectional Study in Malaysia

Abstract

Introduction: This study aims to evaluate the knowledge and confidence of emergency healthcare workers (EHCW) in facing the COVID-19 pandemic. Materials and Methods: A cross-sectional online study using a validated questionnaire was distributed to doctors (MD), assistant medical officers (AMO), and staff nurses (SN) at an urban tertiary Emergency Department. It comprised of 40 knowledge and 10 confidence-level questions related to resuscitation and airway management steps. Results: A total of 135 from 167 eligible EHCW were enrolled. 68.9% (n = 93) had high knowledge while 53.3% (n = 72) possessed high confidence level. Overall knowledge mean score was 32.96/40 (SD = 3.63) between MD (33.88±3.09), AMO (32.28±4.03), and SN (32.00±3.60), P = 0.025. EHCWs with a length of service (LOS) between 4–10 years had the highest knowledge compared to those with LOS <4-year (33.71±3.39 versus 31.21±3.19 P = 0.002). Airway-related knowledge was significantly different between the designations and LOS (P = 0.002 and P = 0.003, respectively). Overall, EHCW confidence level against LOS showed significant difference [F (2, 132) = 5.46, P = 0.005] with longer LOS showing better confidence. MD showed the highest confidence compared to AMO and SN (3.67±0.69, 3.53±0.68, 3.26±0.64) P = 0.049. The majority EHCW were confident in performing highquality chest-compression, and handling of Personal Protective Equipment but less than half were confident in resuscitating, leading the resuscitation, managing the airway or being successful in first intubation attempt. Conclusions: EHCW possessed good knowledge in airway and resuscitation of COVID-19 patients, but differed between designations and LOS. A longer LOS was associated with better confidence, but there were some aspects in airway management and resuscitation that needed improvement. Keywords: Airway; Confidence; COVID-19; Knowledge; Resuscitation (CPR).

A cross-sectional study of assessing knowledge, attitude, and practice of COVID-19 resuscitation among health care workers in a hybrid hospital for COVID-19 in Malaysia

“…This study evaluated respondents’ KAP towards the COVID-19 resuscitation protocol by the ERC. Sixty-eight percent (n = 108) respondents had adequate knowledge on COVID-19 resuscitation, similar to previous studies [ [13] , [15] ]. Majority of the respondents had adequate knowledge on COVID-19 mode of transmission, AGP, and proper PPE usage.…”

“…Emergency HCW are the first point of contact with COVID-19 patients and are at the highest risk of occupational exposure due to AGP during resuscitation [ [9] , [12] ]. Previous studies have evaluated HCW knowledge on COVID-19 infection control [ [13] , [14] , [15] , [16] ]. Bhagavathula et al found a disparity of knowledge and attitude between doctors and allied heatlh personnel on COVID-19 transmission and disease prevention [ 13 ].…”

“…Hossain et al demonstrated that despite 99% of HCW had adequate knowledge on PPE, they had poor practice in correct usage of PPE [ 14 ]. Abd Samat et al had reported 68.9% of emergency HCW had good knowledge, but poor confidence regarding intubation strategies in COVID-19 patients and the risk of viral exposure [ 15 ]. However, these studies were focused on infection control measures [ [13] , [14] , [16] ] or airway management [ 15 ] and COVID-19 resuscitation was not explicitly explored.…”

Japanese medical students’ awareness of cardiopulmonary resuscitation in the context of the COVID‐19 pandemic

“…The results showed that 68.9% of subjects had a high level of knowledge about airway management and cardiopulmonary resuscitation for COVID‐19 patients. 9 Therefore, it may be possible for Japanese medical students to acquire essential knowledge regarding COVID‐19 context CPR and airway management if adequate learning opportunities are provided. Specifically, two‐person bag‐valve mask ventilation with PPE is an essential airway management skill for senior medical students to learn.…”

Rapid training of non-intensivists using an online critical care course during COVID-19

“…6 This involves augmenting the ICU team with non-intensivists, leaving intensivists to perform supervisory roles. Non-intensivist physicians will then need to be equipped with the necessary skills 8 to function efficiently and safely in a critical care team. The need for mass education and avoidance of face-to-face training during a pandemic makes conventional teaching methods (through the use of task trainers and simulation sessions) logistically difficult.…”