7 4 • O
U T P A T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 2 0
A
nesthesia providers have
been forced to alter the
way they work in order
to deliver safe and efficient care
during the COVID-19 pandemic.
Because of their close proximity
to patients and the types of pro-
cedures they perform, anesthesia
professionals are among the
providers most at risk of expo-
sure to the coronavirus.
Fortunately, several straight-
forward interventions can reduce
transmission risks.
The latest
recommendations
The science continues to evolve,
but experts believe COVID-19 is
predominantly transmitted by
droplet spread and through direct
contact. Early research indicates
that the highest viral load appears
in sputum and upper airway secre-
tions. Anesthesia providers are
positioned near the patient's head,
and many procedures they per-
form are aerosol-generating. High-
flow oxygen delivery, endotra-
cheal intubation and extubation, non-invasive venti-
lation and open suctioning of airways all can gener-
ate droplets. Not surprisingly, guidance to help miti-
gate risk associated with airway management cen-
ters on avoiding aerosol-generating procedures
whenever possible. Current professional society
recommendations include:
• Focus on "safe, accurate and swift" airway
management techniques. Multiple attempts to
secure an airway can increase exposure.
Ensure airway devices are easy to use, so endo-
tracheal tubes can be placed on the first try.
• Use suitable alternatives to aerosol-generating
procedures, whenever possible.
• Keep as safe a distance as possible from the
patient's airway while maintaining appropri-
ate technique.
• Use airway management tools and techniques
that lessen the need for prolonged direct
patient contact, which can occur with chin lift
and jaw thrust maneuvers.
• Opt for single-use equipment instead of
reusable devices, when feasible.
Placing (intubating) or removing (extubating) an
endotracheal tube can cause patients to cough.
Research indicates these aerosol-generating
Safe Anesthesia Care During COVID-19
Take precautions to reduce exposure risks to airborne droplets.
Anesthesia Alert
Roxanne McMurray, DNP, APRN, CRNA
PROCESS IMPROVEMENT Now is the time to refine airway management practices that may not have been applied in the
early months of the pandemic.
Pamela
Bevelhymer,
RN,
BSN,
CNOR