Intubation and mechanical ventilation: knowledge of medical officers at a South African secondary hospital

Abstract

Background: Medical officers frequently need to initiate the management of critically ill patients requiring endotracheal intubation and mechanical ventilation. The knowledge of hospital-based medical officers at a South  African secondary hospital was evaluated on indications for endotracheal intubation and the initiation of mechanical  ventilation in adults (defined as persons aged 13 years and older).
Method: Data were collected through questionnaires using 18 multiple-choice questions. Questionnaires consisted of a short test on the basic principles of intubation and the initiation of mechanical ventilation.
Results: Forty-four medical officers participated in this study, conducted in 2008. The mean test score for medical officers taking the test was 6.2, with a range of 2–10, out of a possible 15 marks. 77.3% of participants answered fewer than half of the questions correctly. Nobody answered more than 70% of the questions correctly. More than two thirds of the medical officers could not correctly identify indications for endotracheal intubation, 97.7% of medical officers could not correctly identify all of the contraindications to orotracheal intubation, and 97.7% were unable to choose appropriate initial ventilator settings.
Conclusion: Most medical officers at this secondary hospital were lacking in essential knowledge needed to make decisions on which patients required intubation and how to initiate mechanical ventilation. Pre- and postgraduate training on these basic principles needs to improve.

Keywords: artificial ventilation, intubation, knowledge, mechanical ventilation, medical officers, secondary hospital