In order to reduce the risk of viral dissemination during endotracheal intubation, experts and scholars have been invited to develop the most appropriate intubation process recommendations for the medical team to follow.
The new coronary pneumonia continues to ravage the country, although most patients are mildly ill, but a small number of seriously ill patients may still face respiratory failure, and have to be intubated through the trachea to help the lungs gradually regain their health; Taiwan Anesthesiology Association pointed out that the trachea intubation is an invasive medical treatment, especially when the patient needs to be intubated for treatment of the patient's condition is unstable on the emergency treatment, which is afraid of exposing healthcare personnel to a high risk of infection, and the risk of infection is high. In order to minimize the risk of viral transmission during endotracheal intubation, we have invited experts and scholars to develop recommendations for the most appropriate intubation procedures to be followed by the medical team.
Personal protection is key before intubation
Especially when faced with a patient with severe special infectious pneumonia who needs respiratory care and intubation, healthcare professionals should ensure that they are properly protected, including wearing disposable waterproof one-piece suits, double gloves, masks with an N95 rating or higher, or motorized air-supplied respiratory protection, disposable face shields, and other protective equipment. The first step in the process is to make sure that you are wearing the right type of protective clothing, double gloves, N95-rated (or higher) mask or electric air-supply mask, disposable face shield, etc., and to check the standard physiological monitors, intravenous injections, intubation equipment, medications, respirators, and other equipment, and also try to avoid awake fiber optic cannulae, or else nebulize the local *** fear that the virus will be sprayed into gas.
For difficult intubation, consider an emergent anterior cervical airway
Intubation should be performed in as negative an environment as possible, with rapid-induction intubation, which ensures that skilled assistants are able to perform cricoid cartilage compression, and that NRMs or other respiratory therapy devices are removed only prior to intubation, and that single-phase laryngoscopes are used for intubation. The use of a single-throw imaging laryngoscope during intubation not only distances the patient from the mouth and nose, but also enhances the field of vision. The Taiwan Society of Anesthesiologists emphasizes that, if intubation is unsuccessful, a supraglottic airway can be considered via the mouth, but if intubation is still difficult, an emergency anterior cervical airway (eFONA) can be considered ahead of time.
To avoid touching yourself without washing your hands
In addition, all airway equipment must be sealed with a double-zip plastic bag for decontamination and disinfection, and as long as you leave the negative-pressure ward, in addition to the assistant should be in accordance with the provisions of the hospital for equipment disinfection, take down the protective equipment, but also to avoid touching the hair, face and eyes before washing your hands, to avoid infection.
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