Expert Recommendations for Tracheal Intubation in Critically ill Patients with Noval Coronavirus Disease 2019.
Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih · 2020-02-27 · Guideline / consensus
Abstract
Coronavirus Disease 2019 (COVID-19), caused by a novel coronavirus (SARS-CoV-2), is a highly contagious disease. It firstly appeared in Wuhan, Hubei province of China in December 2019. During the next two months, it moved rapidly throughout China. Most of the infected patients have mild symptoms including fever, fatigue and cough, but in severe cases, patients can progress rapidly and develop into acute respiratory distress syndrome, septic shock, metabolic acidosis and coagulopathy. The new coronavirus was reported to spread via droplets, contact and natural aerosols from human to human. Therefore, aerosol-producing procedures such as endotracheal intubation may put the anesthesiologists at high risk of nosocomial infections. In fact, SARS-CoV-2 infection of anesthesiologists after endotracheal intubation for confirmed COVID-19 patients have been reported in hospitals in Wuhan. The expert panel of airway management in Chinese Society of Anaesthesiology has deliberated and drafted this recommendation, by which we hope to guide the performance of endotracheal intubation by frontline anesthesiologists and critical care physicians. During the airway management, enhanced droplet/airborne personal protective equitment (PPE) should be applied to the health care providers. A good airway assessment before airway intervention is of vital importance. For patients with normal airway, awake intubation should be avoided, and modified rapid sequence induction is strongly recommended. Sufficient muscle relaxant should be assured before intubation. For patients with difficult airway, good preparation of airway devices and detailed intubation plans should be made.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
COVID-19 pandemic · Endotracheal intubation · Muscle relaxants · Rapid sequence intubation
Related articles
- Impact of the Coronavirus Pandemic on Patients Requiring Tracheal Intubation by Helicopter Emergency Medical Services: A Retrospective, Single-Center, Observational Study. (J Clin Med, 2024)
- Emergency tracheal intubation immediately following traumatic injury: an Eastern Association for the Surgery of Trauma practice management guideline. (J Trauma Acute Care Surg, 2012)
- Patient safety in pre-hospital emergency tracheal intubation: a comprehensive meta-analysis of the intubation success rates of EMS providers. (Crit Care, 2012)
- Definitive Airway Management in the Critical Care Transport Medicine Environment: An Exploratory Convenience Survey-Based Analysis of Retrieval Experts on the Profound Shock State Patient. (Air Med J, 2026)
- Succinylcholine improves the time of performance of a tracheal intubation in prehospital critical care medicine. (Eur J Anaesthesiol, 2002)
- Emergency tracheal intubation of severely head-injured children: changing daily practice after implementation of national guidelines. (Pediatr Crit Care Med, 2011)