Abstract
BackgroundThe Coronavirus infectious disease 2019 (COVID-19) brings anesthesiologists and intensive care physicians to the mainstay of clinical workload and healthcare managements’ focus. There are approximately 900 anesthesiologists in Israel, working in non-private hospitals. This nationwide cross-sectional study evaluated the readiness and involvement of anesthesia departments in Israel in management of the COVID-19 pandemic. The impact on anesthesiologists’ health, workload, and clinical practices were also evaluated.MethodsAn online questionnaire was distributed to all of anesthesia department chairs in Israel on April 14th. Each response was identifiable on the hospital level only. Informed consent was waived since no patient data were collected.ResultsResponse rate was 100%. A decrease of at least 40% in operating-room activity was reported by two-thirds of the departments. Anesthesiologists are leading the treatment of COVID-19 patients in 19/28 (68%) Israeli hospitals. Israel Society of Anesthesiologists’ recommendations regarding intubation of COVID-19 patients were strictly followed (intubations performed by the most experienced available physician, by rapid-sequence induction utilizing video-laryngoscopy, while minimizing the number of people in the room - about 90% compliance for each). Anesthesiologists in most departments use standard personal protective equipment when caring for COVID-19 patients, including N95 masks, face shields, and water-proof gowns. Only one anesthesiologist across Israel was diagnosed with COVID-19 (unknown source of transmission). All department chairs reported emerging opportunities that advance the anesthesia profession: implementation of new technologies and improvement in caregivers’ clinical capabilities (68% each), purchase of new equipment (96%), and increase in research activity (36%).ConclusionsThis nationwide cross-sectional study had a complete response rate and therefore well-represents the anesthesia practice in Israel. We found that Israeli anesthesia departments are generally highly involved in the health system efforts to cope with the COVID-19 pandemic. Anesthesia and airway management are performed in a remarkably comparable manner and with proper protection of caregivers. Ambulatory anesthesia activity has dramatically decreased, but many departments find opportunities for improvement even in these challenging times.
Highlights
The Coronavirus infectious disease 2019 (COVID-19) brings anesthesiologists and intensive care physicians to the mainstay of clinical workload and healthcare managements’ focus
The main topics addressed by the survey were anesthesiologists’ level of involvement in the COVID-19 crisis management, use of different components of protective equipment (PPE), modifications to the anesthesia induction and airway management methods, ramifications of the crisis on anesthesiologists’ health and availability, and perceived opportunities arising from the situation
There was no difference between hospitals in which the intensive care unit (ICU) is part of the anesthesia department (6/9, 67%) and those in which they are Anesthesia activity: As for elective surgical volume and anesthesia services, two thirds of departments reported a decrease of at least 40% in operating room activity (19/ 28, 68%), and 75% of departments reported cancellation of non-operating-room anesthesia cases
Summary
The Coronavirus infectious disease 2019 (COVID-19) brings anesthesiologists and intensive care physicians to the mainstay of clinical workload and healthcare managements’ focus. There are approximately 900 anesthesiologists in Israel, working in non-private hospitals. This nationwide cross-sectional study evaluated the readiness and involvement of anesthesia departments in Israel in management of the COVID-19 pandemic. Anesthesiologists are considered experts in airway management, mechanical ventilation, and intensive care. There are approximately 900 anesthesiologists in Israel working in non-private hospitals, caring for a national population of about 9 million people. The ISA has published its recommendations for safe airway management of patients suspected to carry SARS-CoV-2, including the use of N95 masks and goggles / face shields, but the adherence to these recommendations in light of the national shortage of PPE remains unknown. The magnitude of SARSCoV-2 infection in anesthesia personnel is unknown
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