ABSTRACT
Evidence shows videolaryngoscopy (VL) creates a safe atmosphere for tracheal intubations by reducing failed intubations and increasing first-pass success [1]. In 2017, University College London Hospital was one of the first hospitals in the UK to roll out VL to all anaesthetic areas to promote patient safety at a time of increased airway complexity cases. We aim to compare staff attitudes about VL at the time of introduction and 3-years later. Methods We sent online surveys to anaesthetists of all grades before and after the introduction of VL. We had over 90 responses to both surveys. Results Our survey results show that anaesthetists are becoming more in favour of VL with > 93% supporting their use. They show 78% gave VL a maximum +5 on the Likert scale;this is an increase from 59% in the initial survey. It indicates that > 88% perceive VL to promote patient safety, improve quality of care, help in training and improve team dynamics of the intubation process. We see overwhelming support for their use in COVID-19 patients with only 1% of survey respondents having negative views. Subjective responses show that clinicians perceived VL to add 'patient and operator safety'. This is due to 'increased distance of operator from the airway';'reducing anticipated infection risk' and 'improving ease of intubation in the hypoxic patient'. They also feel that VL helps 'share a mental model with the team when other aspects of communication are impaired by PPE'. Our surveys demonstrate fewer concerns with VL over the 3-year period. The results show that concerns amongst anaesthetists with regard to training and familiarity had dropped from 33% to 25%. Concerns over the use of single-use equipment had decreased from 81% to 66%, and concerns regarding documentation of VL intubation grades dropped from 59% to 38%;however, there remains a small but noticeable increase in concern over the loss of direct laryngoscopy skills amongst junior anaesthetists from 55% to 64%. Discussion Our surveys demonstrate a department-wide change in attitude that favours the use of VL. Crucially, clinicians feel that VL provides a strong positive patient safety effect and promotes shared decision-making at a time when rare catastrophic events such as unrecognised oesophageal intubation still occur. The pandemic has proven to be a major catalyst for their increased use and familiarity, which is likely to propel the widespread use of VL in the future.