C
OVID-19 has all healthcare
workers on edge — espe-
cially those involved in air-
way management. The
coronavirus is found in spu-
tum and upper airway secretions, putting
anesthesia providers in a direct pathway of
exposure during intubations. Minimizing
the risk of transmission during these high-
risk procedures requires careful prepara-
tion, necessary equipment and experi-
enced anesthesia providers who can trou-
bleshoot unforeseen complications.
Adhering to the following recommenda-
tions (osmag.net/n7JbED) issued by the
American Association of Nurse
Anesthetists will help keep your anesthe-
sia providers and surgical team safe when
treating patients who are suspected of hav-
ing COVID-19.
1. Rely on the experts
Anesthesia professionals within your facili-
ty who have the most experience in airway
management should perform intubations
during cases involving patients with sus-
pected COVID-19. This isn't role-specific.
For instance, if nurse anesthetists are the
most frequent intubators on your anesthe-
sia team, they should secure airways. This will mini-
mize the time it takes to secure an airway because
you should not be bagging a patient during this pro-
cedure. The goal is to safely minimize the likelihood
of aerosolizing airway content. You want to rely on a
provider who is highly experienced, who can intu-
bate quickly and efficiently, and who has the most
likelihood of doing it in one attempt.
Additionally, limit the number of staff members
present during airway manipulation to reduce the
risk of unnecessary exposure. CDC guidelines say
only staff who are critical to managing the airway
or making sure the procedure runs safely should be
in the environment where it's occurring. In many
cases, that's only the anesthesia provider who's
physically securing the airway. But the provider
may require the assistance of a registered nurse.
That's OK, but the rest of the OR staff should be
out of the environment. It's important that each
facility has a clearly defined policy that states who
the critical members of the airway management
team are, who should be assisting and who should
be out of the environment while the intubation is
taking place.
J
A N U A R Y 2 0 2 1 • O U T P A T I E N T S U R G E R Y . N E T • 2 9
Brett Morgan, DNP, CRNA I Park Ridge, Ill.
Airway Management in the COVID-19 Era
Anesthesia providers must take additional
steps to perform intubations safely and effectively.
DRESSED IN LAYERS The pandemic has highlighted the importance of wearing proper protection
when intubating patients.
Rebecca
Barnett
