title: Awake intubation creates feelings of being in a vulnerable situation but cared for in safe hands: a qualitative study.
abstract: Awake fiberoptic intubation is an alternative procedure for securing the airway and is a recommended option when a difficult airway is expected. The aim of the present study was to describe patient experiences with this procedure.
  
  
  
  A qualitative, descriptive design was used and patients were recruited from three county hospitals and one university hospital in Sweden. Data was collected by semi-structured interviews with 13 patients who underwent awake fiberoptic intubation. A qualitative content analysis extracted theme, categories, and subcategories.
  
  
  
  From the patient statements, one main theme emerged, feelings of being in a vulnerable situation but cared for in safe hands, which were described in five categories with 15 subcategories. The categories were: a need for tailored information, distress and fear of the intubation, acceptance and trust of the staff's competence, professional caring and support, and no hesitation about new awake intubation. The patients felt they lacked information about what to expect and relied on the professionals' expertise. Some patients felt overwhelmed by the information they were given and wanted less specific information about the equipment used but more information about how they would be cared for in the operating room. Undergoing awake intubation was an acceptable experience for most patients, whereas others experienced it as being painful and terrifying because they felt they could not breathe or communicate during the procedure itself.
  
  
  
  Tailored information about what to expect, ensuring eye contact and breathing instruction during the procedure seems to reduce patient distress when undergoing awake fiberoptic intubation. Most of the patients would not hesitate to undergo awake intubation again in the future if needed.
authors: Department of Public Health and Caring Sciences, Uppsala University, SE 751 22, Uppsala, Sweden. kati.knudsen@hig.se.|Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, SE 801 76, Gävle, Sweden. kati.knudsen@hig.se.|Centre for Research & Development, Uppsala University/Region Gävleborg, SE 801 88, Gävle, Sweden. kati.knudsen@hig.se.
authors: Kati
authors: K
authors: Knudsen
authors: Faculty of Medicine and Health, School of Health Sciences, Örebro University, SE 701 82, Örebro, Sweden.
authors: Ulrica
authors: U
authors: Nilsson
authors: Centre for Research & Development, Uppsala University/Region Gävleborg, SE 801 88, Gävle, Sweden.|Department of Medical Sciences, Uppsala University, SE 751 22, Uppsala, Sweden.
authors: Marieann
authors: M
authors: Högman
authors: Department of Public Health and Caring Sciences, Uppsala University, SE 751 22, Uppsala, Sweden.
authors: Ulrika
authors: U
authors: Pöder
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D004644:Emotions; D005239:Fear; D005260:Female; D005336:Fiber Optic Technology; D006766:Hospitals, County; D006785:Hospitals, University; D006801:Humans; D007407:Interviews as Topic; D007442:Intubation, Intratracheal / Q000379:methods / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000453:epidemiology*; D013548:Sweden; D014851:Wakefulness
keywords: Anaesthesia care; Awake fiberoptic intubation; Qualitative study