Knowledge, attitude, and practice of the use of personal protective equipment and its psychological impact among Indian anesthesiologists during the COVID-19 pandemic

Background:
Anesthesiologists, with their skills and expertise at performing various aerosol-generating procedures such as tracheal intubation and extubation, tracheostomies, and bronchoscopy-guided procedures, serve as frontline workers during the COVID-19 pandemic. They are exposed to the risk of infection as well as highly stressful environments in the operating theaters and intensive care units. Appropriate knowledge, attitudes, and practices (KAPs) with regard to the use of personal protective equipment (PPE) will help mitigate some of this stress.


Materials and Methods:
Owing to the nation's lockdown situation, an online questionnaire-based survey was conducted through WhatsApp, Facebook, and E-mail among anesthetists working at different health-care sectors in India. The KAP with regard to the use of PPE during the COVID-19 and its psychological impact were assessed by using a prevalidated questionnaire. All analyses were performed using SPSS version 25.


Results:
Among 301 study participants, 189 (62.8%) had good knowledge and 90% had favorable attitudes. Despite 66.4% of the study participants having received formal training regarding the use of PPE during the COVID-19 pandemic, good practices were seen only in 44.4%. Irrespective of the demographic variable assessed, 90% of the anesthesiologists felt that working was more stressful in the operating room during this pandemic, due to challenges with respect to effective communication, restrictions in movement and visibility attributed to PPE as well as an alteration in the usual routine.


Conclusions:
Despite adequate knowledge and attitudes regarding the use of appropriate PPE, the translation into practice was deficient. Emphasis on the checklist, protocol-based approaches, and regular updates on practice recommendations will help to improve adherence to quality practices. Donning of appropriate PPE contributes to significant physical and emotional stress among anesthesiologists during the COVID-19 pandemic. A platform to provide psychological support is the need of the hour.