priate donning and doffing of PPE that corresponds
to your patient population and the procedures being
performed. Have your staff review and practice the
PPE donning protocol with a colleague, so they can
make sure they're doing the right things in the right
order, and aren't missing minor but critical steps.
4. Focus on infection control
Hand washing is one of the most important steps
in preventing the transmission of any infectious
disease. There are challenges surrounding hand
hygiene during the process of administering anes-
thesia and airway manipulation, particularly
because it involves virus aerosolization. Therefore,
anesthesia providers are at a higher risk for being
exposed to COVID-19 and need to be extra diligent
about treating their hands after every case. Be sure
to audit providers' adherence to your facility's
hand hygiene policy. Also follow strict environ-
mental cleaning and disinfection procedures in
and around the anesthesia workstation. Dispose of
all used airway equipment in a double-zip-locked
plastic bag for proper decontamination and disin-
fection. The burden is on your facility to have
clearly defined environmental cleaning and disin-
fection policies in place, and to ensure anesthesia
providers follow them consistently.
5. Segregate high-risk patients
Allocate ORs specifically for patients with confirmed
or suspected COVID-19. Also, these patients should
not be brought to preop or recovery areas. If you
have the opportunity to segregate patients with
COVID-19, that's your best and safest option. Of
course, this depends on location. In communities
with high viral spread, providers should assume every
patient is positive unless they present a negative test.
In communities where viral spread is less severe, you
can be slightly more relaxed. This recommendation is
meant to be tailored to a facility's current patient pop-
ulation and exposure to the virus.
Availability to COVID-19 testing
will ultimately dictate the way your
facility handles OR allocation.
Opportunity for
improvement
COVID-19 highlighted the risk that
providers who engage in airway
management face on a regular
basis and has also drawn much-
needed attention to the need for
clearer, evidence-based infection
control policies and procedures in
this area. Prior to the pandemic, I
don't think airway experts did the
best job at addressing infection
control practices during airway
management. The pandemic has
provided that chance. It's time to
take advantage of it.
OSM
3 2 • S U P P L E M E N T
T O 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 • J A N U A R Y 2 0 2 1
Dr. Morgan
(bmorgan@aana.com) is the
senior director of education
and practice for the American
Association of Nurse
Anesthetists in Park Ridge, Ill.
