ABSTRACT

Background: The Novel Corona virus spread from Wuhan, a city of Hubei province in China since December 2019. Corona Virus disease (COVID-19) is highly contiguous and transmitted easily through droplets, aerosol As Such, it carries a high risk of spread to health professionals especially the anesthesia care team trained to secure the patients airway. During current pandemic almost all elective surgeries were cancelled and emergency surgical procedures were performed for suspected or confirmed COVID-19 positive patients. Performing surgical procedure or securing an airway in COVID-19 patients, special attention and the recommended guidelines must be followed for health professional safety. Safely securing a patient’s airway promptly using rapid sequence induction with muscle relaxant is challenging. Video laryngoscopy can increase mouth to mouth distance and its use is recommended in place of conventional laryngoscopy with goggles coated besides with an antifogging agent. When performing a surgical procedure on a COVID-19 patient, it is recommended to have a limited number of well trained staff who have plenty of knowledge on how to don and doff personal protective equipment’s (PPE) in the operating room (OR).Pre-oxygenation with 100% oxygen for 3-5minutes with tight fitting mask using AE technique and lidocaine 1.5mg/kg is recommended in order to avoid coughing during intubation. Post-op muscle relaxant used video laryngoscopes and monitor End tidal carbon dioxide (ETCO2) to check the placement of tube. Necessary equipment and mask should be ensuring to the patient at time of extubation and avoid the high nasal flow oxygen to prevent aerosol. Conclusion: This review highlighted important steps of tracheal intubation in patients suffering from COVID-19 presenting for emergency surgery. A special consideration should also be given to include limited staff in the OR, negative pressure air room with advance and well prepared intubation trolley along with video laryngoscope. An expert and highly sophisticated trained anesthetist with one assistant should follow the intubation procedure and avoid the high nasal flow to prevent aerosol in order to minimize the risk of getting infected. Key words: End tidal carbon dioxide (ETCO2); Operating room (OR); Personal protective equipment (PPE); severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2); Endotracheal tube (ETT); Rapid sequence induction (RSI)
Publication date: 01/03/21

https://ijbpas.com/pdf/2021/March/MS_IJBPAS_2021_5415.pdf

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https://doi.org/10.31032/IJBPAS/2021/10.3.5415