Assistance with Anaesthetic Interventions outside the Intensive Care Unit: Results from a National Survey of Practice and of Medical Staffing

We undertook a web-based survey of intensive care units (ICUs) in England, Wales and Northern Ireland in order to deter-mine which groups of healthcare professionals were routinely being used to assist with stabilisation of critically ill patients outside the ICU. We also investigated what support was immediately available to patients with acute airway problems on the units themselves. We found that assistants often lack the training required to safely assist the ICU doctor. Out of hours, almost 38% of hospitals use under-skilled assistants during emergency intubations. Over 50% of units rely on theatre anaesthetists or non-resident consultants for emergency airway support if the ICU doctor is not available. To ensure patient safety, formal guidelines should be introduced at national and local levels to identify who should be assisting with stabilisation of critically ill patients and what level of training they should receive. This should be subject to regular audit.