Mechanical Ventilation Practices of Turkish Emergency Physicians: A National Survey

Objectives The objective of this study is to ascertain the mechanical ventilation management skill perception levels of emergency physicians in Turkey as well as to determine the infrastructural condition of ED in Turkey with respect to mechanical ventilation. Methods We distributed a survey to all emergency physicians in Turkey. The contents of the survey consisted of 4 main areas that paralleled the objectives of the study. (1) Socio-demographic characteristics, (2) the situation of the personnel and the technical infra-structure in the ED (3) the Emergency Medicine Training Program (EMTP) and post graduate training, and (4) suggested solutions. Each physician's perception level was evaluated with a 10 cm Visual Analogue Scale. Results Four-hundred emergency physicians participated in the study (response rate = 70.5%). The means of the emergency physicians' perceptions as to whether or not the personnel and technical infrastructure for mechanical ventilation management are adequate in the institutions in which they work were 3.2 +/- 2.4 cm and 3.4 +/- 2.4 cm, respectively. It was determined that 75.5% of the participants did not receive any education regarding mechanical ventilation management during their emergency medicine education program. The means of the physicians' perception levels regarding the number of times they practiced mechanical ventilation during their emergency medicine education program was 4.6 +/- 2.2 cm, and the means of their perception levels regarding their own knowledge and skills on mechanical ventilation management was 5.4 +/- 2 cm. It was determined that during mechanical ventilation, 29.5% of emergency physicians had not used any sedative agents, and 30.2% of them had not used any paralyzing agents. It was also determined that midazolam (30.7%) was used most frequently for sedation, fentanyl (50.7%) was used most often for analgesia, and vecuronium (27%) was used most frequently as a neuromuscular blocker. The most frequently reported problem regarding formal mechanical ventilation management set forth by the participants was that theoretical and practical education was not standard. Conclusions The skill perception level of emergency physicians regarding mechanical ventilation management is low. Having an intensive care unit in the emergency department or having a clinic chief who is an emergency physician as director increased the perception level of physicians who participated in an emergency medicine education program about mechanical ventilation management. Both the mechanical ventilation management education in emergency medicine education programs and the infrastructural conditions of emergency departments with respect to mechanical ventilation were considered to be inadequate by emergency physicians.