A survey into training and support for staff redeployed into critical care during the COVID-19 pandemic to optimise preparations for a second wave

Following the changes that have occurred during the emergency response of the coronavirus pandemic, guidelines were released on the use of videolaryngoscopy (VL) for all suspected COVID-19-positive patients as a first line [1] There has been evidence of improved visualisation with videolaryngoscopes;however, this may differ dependent on the angulation of the blade used Although there have been a number of changes in practice following the pandemic, the use and availability of videolaryngoscopes has increased We therefore wanted to conduct a snapshot questionnaire reviewing if this has changed anaesthetic practice for the future This was undertaken in a district general hospital with tertiary services for maxillofacial and ear-nose-throat (ENT) surgery Methods A survey was distributed to all anaesthetists at Royal Surrey County Hospital via a web-based link, containing questions on first-choice laryngoscope use prior to COVID-19 and current first choice, concerns and problems with VL and numbers of intubations performed since the pandemic Results Forty-one out of 74 anaesthetists returned the questionnaire out of which 88% of responders stated using a VL as recommended by national guidance, 63% for difficult airways, 48% in order to reduce the infection risk and 35% stated less trauma Prior to the pandemic, 80% of responders were using a MAC laryngoscope as their first choice, whereas currently 82% stated use of a McGarth as their first-line laryngoscope Sixty-five per cent of responders reported concerns regarding deskilling In total, 60% of responders were encouraging the change to convert to the use of videolaryngoscopes as a first-choice laryngoscope for all intubations Discussion Overall, this survey has shown that the use of videolaryngoscopes as a first-line intubation aid has majorly increased following the coronavirus pandemic with a departmental opinion to shift towards changing to universal laryngoscopy It has been acknowledged that with increasing use of videolaryngoscopes, trainees have raised concerns regarding having less skills using conventional laryngoscopy This can be a patient safety concerns when considering intubations in locations that might not have easy access to videolaryngoscopes, such as computed tomography and magnetic resonance imaging Moreover, for experienced anaesthetists who prefer direct visualisation and use of a MAC has been standard practice, it might be difficult to shift away from longstanding practices