Knowledge and practice of tracheal tube cuff pressure monitoring: a multicenter survey of anaesthesia and critical care providers in a developing country.

BACKGROUND: Tracheal tubes are routinely used during anaesthesia and in the intensive care unit. Subjective monitoring of cuff pressures have been reported to produce consistently inappropriate cuffs pressures, with attendant morbidity. But this practice of unsafe care remains widespread. With the proliferation of intensive care units in Nigeria and increasing access to surgery, morbidity relating to improper tracheal cuff pressure may assume a greater toll. We aimed to evaluate current knowledge and practice of tracheal cuff pressure monitoring among anaesthesia and critical care providers in Nigeria. METHODS: This was a multicenter cross-sectional study conducted from March 18 to April 30, 2021. The first part (A) was conducted at 4 tertiary referral hospitals in Nigeria by means of a self-administered questionnaire on the various cadre of anaesthesia and critical care providers. The second part (B) was a nation-wide telephone survey of anaesthesia faculty fellows affiliated to 13 tertiary hospitals in Nigeria, selected by stratified random sampling. RESULTS: Only 3.1% (6/196) of the care providers admitted having ever used a tracheal cuff manometer, while 31.1% knew the recommended tracheal cuff pressure. The nationwide telephone survey of anaesthesia faculty fellows revealed that tracheal cuff manometer is neither available, nor has it ever been used in any of the 13 tertiary hospitals surveyed. The 'Pilot balloon palpation method' and 'fixed volume of air from a syringe' were the most commonly utilized method of cuff pressure estimation by the care providers, at 64.3% and 28.1% respectively in part A survey (84.6% and 15.4% respectively, in the part B survey). CONCLUSION: The use of tracheal cuff manometer is very limited among the care providers surveyed in this study. Knowledge regarding tracheal cuff management among the providers is adjudged to be fair, despite the poor practice and unsafe care.

Oxygen saturation and perceived discomfort with face mask types, in the era of COVID-19: a hospital-based cross-sectional study.

INTRODUCTION: the COVID-19 pandemic has necessitated the prolonged use of facemasks by healthcare workers. Facemask non-compliance has been largely blamed on discomfort associated with the mask, and apprehension regarding potential health hazards such as asphyxia from mask usage. We sought to evaluate the impact of different respiratory mask types on the comfort of healthcare workers and their arterial oxygen saturation during periods of active clinical duty. METHODS: we conducted a cross-sectional study on healthcare workers donning different types of facemasks in the normal course of duty. Objective non-invasive determination of arterial oxygen saturation of each participant was done using a portable pulse oximeter. Subjective self-assessment of global discomfort was scored by means of a 11-point numerical scale from 0 (no discomfort) to 10 (worst discomfort imaginable). The user's perceived elements of the discomfort were also evaluated. A statistical significance was accepted when P <0.05. RESULTS: seventy-six healthcare workers completed the study, and wore the masks for periods ranging from 68-480 minutes. The discomfort experienced with the use of the N95 mask; 4.3 (2.0) was greater than the surgical mask; 2.7 (1.8); P=0.001. No significant change in arterial oxygen saturation was observed with the use of either of the mask types. The tight strapping of the N95 mask was perceived as a contributor to the discomfort experienced with mask usage; P=0.009. CONCLUSION: the N95 masks imposed greater discomfort than the surgical masks, but neither of the masks impacted on the arterial oxygen saturation of the healthcare workers.

Patient safety awareness among 309 surgeons in Enugu, Nigeria: a cross-sectional survey.

BACKGROUND: Adverse healthcare events are major public health problem with the heaviest burden in the low and middle-income countries. Patient safety awareness among healthcare professionals is known to impact this outcome; thus we set out to appraise the patient safety awareness among surgeons in Enugu, Nigeria. METHODS: A multi-institutional cross-sectional survey was carried out among surgeons in Enugu, Nigeria and data obtained were analyzed using the statistical package for scientific solutions (SPSS) version 20 software. RESULTS: A total of 309 surgeons were surveyed. Majority of the surgeons (51.9%) had poor perception of patient safety issues. One hundred and twenty respondents (38.8%) have awareness of any institutional protocol for preventing wrong-site surgery while only 35 respondents (11.3%) regularly practiced an institutional protocol for preventing wrong-site surgery. The professional status of the surgeons and years in service showed significant association with perception of patient safety issues. CONCLUSION: The patient safety awareness and practice among the surgeons in Enugu, Nigeria is apparently low and this was found to be influenced by the professional status and years in service of the surgeon.