P188 Respiratory medicine trainees' experience with large bore chest drains: results from a UK wide national survey. (December 2018)

• Record Type: Journal Article
• Authors: Abi Musa Asa'ari, AKA; Irshad, S; Maqsood, U; Piracha, S; Maddekar, N; Khan, SLA; Haris, M; Ganaie, MB
• Is Part Of: Thorax. Volume 73(2018)Supplement 4
• Page Start: A202
• Page End: A203
• Publication Date: 2018-12
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2018-212555.345
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: Seldinger chest drains (SCD) are safe, less invasive and better tolerated compared to large bore chest drains (LBCD) via blunt dissection. Respiratory Medicine specialty trainees (ST) curriculum in UK recommends 'experience of LBCD and competence in SCD.' LBCD are now widespread with the popularity of Thoracoscopy and are arguably safer in complex cases in experienced hands. There is limited data on training, access to teaching and competency in LBCD by Respiratory Medicine STs. Aim: We aimed to study UK based Respiratory Medicine STs experience with LBCD. Methods: A 15-question survey was designed using the SurveyMonkey web tool and was sent to Respiratory Medicine STs in 14 deaneries across the UK. Data was collected on STs' deanery, year of training, competence in SCD and LBCD, access to training and experience in placing, securing and removing LBCD, availability of cardiothoracic surgery (CTS) and treatment delays incurred due to lack of training in LBCD and/or non-availability of CTS. Results: 147 STs completed the survey. 143 STs (97.3%) were competent in SCD but only 22 STs (14.9%) were competent in LBCD. Only 29 STs (19.7%) were competent in securing LBCD and 52 STs (35.3%) were competent in removing LBCD. 84 STs (57.1%) had not received any formal training in LBCD and 129 STs (87.7%) felt they were not getting sufficient experience in LBCD. 77 STs (52.3%) remarked that patients had faced treatment delays due to lack of physician LBCD expertise and/or CTS non-availability. Conclusion: LBCD are becoming commonplace but the experience has declined in Respiratory Medicine STs. An overwhelming majority of Respiratory Medicine STs in the UK believe that they should be getting more experience and training in LBCD. Respiratory Medicine training curriculum may need revision to accommodate the views and improve training of STs.