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Chapter 38 - Airway Management in a Respiratory Epidemic or Pandemic

from Section 3 - Airway Management: Organisation

Published online by Cambridge University Press:  03 October 2020

By
Tim Cook  and
Massimiliano Sorbello
Edited by
Tim Cook  and
Michael Seltz Kristensen
Tim Cook
Affiliation:
Royal United Hospital, Bath, UK
Michael Seltz Kristensen
Affiliation:
Rigshospitalet, Copenhagen University Hospital, Denmark
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Summary

The virus responsible for the coronavirus-19 pandemic is predominantly spread by droplet and contact routes of transmission. Many airway management interventions, particularly when applying positive pressure to the airway, generate aerosol particles which pose a further risk of airborne viral transmission. The fundamental principles of airway management in the setting of a respiratory epidemic are not changed but it is essential to maximise safety for both the patient and all staff involved in caring for them. The airway manager should fully understand and apply principles of infection prevention and control, including understanding and matching personal protective equipment (PPE) to the prevailing mode of viral transmission. Airway management should be meticulously planned, safe for the patient and staff, be undertaken by skilled operators using reliable, well-practised techniques and should aim to achieve high first-attempt success rates so that securing the airway is timely and swift.

Keywords

AirwaycoronavirusCOVID-19pandemicpersonal protective equipment
Type
Chapter
Information
Core Topics in Airway Management , pp. 321 - 330
Publisher: Cambridge University Press
Print publication year: 2020

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References

Further Reading

Brewster, DJ, Chrimes, NC, Do, TBT, et al. (2020). Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. Medical Journal of Australia (in press).CrossRefGoogle Scholar
Cook, TM. (2020). Personal protective equipment during the COVID-19 pandemic – a narrative review. Anaesthesia. doi:10.1111/anae.15071.CrossRefGoogle Scholar
Cook, TM, El-Boghdadly, K, McGuire, B, et al. (2020). Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists, the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists. Anaesthesia. doi:10.1111/anae.15054.CrossRefGoogle Scholar
Gralton, J, Tovey, E, McLaws, ML, Rawlinson, WD. (2011). The role of particle size in aerosolised pathogen transmission: a review. Journal of Infection, 62, 1–13.CrossRefGoogle ScholarPubMed
Lockhart, SL, Duggan, LV, Wax, RS, Saad, S, Grocott, HP. (2020). Personal protective equipment (PPE) for anesthesiologists and other airway managers: principles and practice during the COVID-19 pandemic. Canadian Journal of Anaesthesia (in press).CrossRefGoogle Scholar
Meng, L, Qiu, H, Wan, L, et al. (2020). Intubation and ventilation amid the COVID-19 outbreak: Wuhan’s experience. Anesthesiology. doi:10.1097/ALN.0000000000003296. [Epub ahead of print]Google Scholar
Nicolle, L (2003). SARS safety and science. Canadian Journal of Anaesthesia, 50, 983–988.CrossRefGoogle ScholarPubMed
Sorbello, M, El-Boghdadly, K, Di Giacinto, I, et al. (2020). The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice. Anaesthesia. doi:10.1111/anae.15049. [Epub ahead of print]CrossRefGoogle Scholar
Tran, K, Cimon, K, Severn, M, Pessoa-Silva, CL, Conly, J. (2012). Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One, 7, e35797.CrossRefGoogle ScholarPubMed
van Doremalen, N, Bushmaker, T, Morris, DH, et al. (2020). Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England Journal of Medicine, 382, 1564–1567. doi:10.1056NEJMc2004973.CrossRefGoogle ScholarPubMed
Yao, W, Wang, T, Jiang, B, et al. (2020). Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations. British Journal of Anaesthesia (in press). doi:https://doi.org/10.1016/j.bja.2020.03.026.CrossRefGoogle Scholar

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