Difference between revisions of "WLAVA:COVID19 ED Airway"

(SUGGESTED WORKFLOW FOR AIRWAY BOX)
 
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'''Last Updated: 4/9/20'''
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'''Last Updated: 5/24/20'''
==COVID Airway Intubation==
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==COVID AIRWAY INTUBATIONS==
 
* '''Reference document:'''
 
* '''Reference document:'''
 
** [[File:COVID intubation guideline update 3.30.20.pdf]]
 
** [[File:COVID intubation guideline update 3.30.20.pdf]]
  
===Airway Supplies===
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===AIRWAY SUPPLIES===
 
* Airway carts are located across charge nurse station. These have PAPR, PPE, and airway equipment including viral filters.  
 
* Airway carts are located across charge nurse station. These have PAPR, PPE, and airway equipment including viral filters.  
 
* Code is 1212  
 
* Code is 1212  
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** Contact SPS M-F 41811, Weekends 310-987-8710 or 323-497-4585. They will pick up, clean and deliver back to ED.  
 
** Contact SPS M-F 41811, Weekends 310-987-8710 or 323-497-4585. They will pick up, clean and deliver back to ED.  
  
===3rd Overnight Weekday 11p-7a and Weekend 7p-7a (COVID-19) Attending Duties===  
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===BASIC TECHNIQUE TO TEMPORARILY SECURING AN ET TUBE===
* Airway management for crash COVID patients.
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{{#widget:YouTube|id=dMARECkwt7s}}
* Help other attendings with ED patient load.
 
* At the beginning of the shift, complete daily item log as below.
 
====DAILY LOG====
 
* The COVID Airway Shift Attending must check the Airway Carts x2 and new red Airway Box in the med room every day.
 
* The DAILY “Sign-off Log” and the “Item Checklist” are on separate clipboards on '''top the Airway Cart'''.
 
* Best practice is to refill the cart after an intubation because you know what is missing.
 
* This daily log is a double check / insurance.
 
* You also need to check that the COVID medication bags medications are NOT expired.
 
[[File:clipboard.jpg|100px]]
 
[[:File:Airway Cart Box Item Checklist_042020.pdf|COVID Airway Item Checklist]]
 
  
====AIRWAY RED BOX IN MED ROOM====
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===SECURING AN ET TUBE WHILE USING AN AIRWAY BOX===
* Stored in Med Room
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{{#widget:YouTube|id=_CBRZfse9Hs}}
* Check Daily (3 essential items)
 
** Glidescope Go ('''CHECK BATTERY''')
 
** Grab and Go Bag (premade ones in Yellow Duffel Bag)
 
** COVID Medication Bag
 
[[File:red box.jpg|100px]]
 
  
====AEROSOL (ACRYLIC/PLEXIGLASS) BOX====
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===DEMONSTRATION OF USING A PONCHO WHILE INTUBATING===
* Stored in the Doctor's station.
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{{#widget:YouTube|id=JP7V6pb9new}}
* This is available for use and is not mandatory.
 
** Added layer of protection (giant splash guard).
 
* We recommend you practice using it on simulation dummy before deploying for COVID19 airway.
 
* Bed 4 has intubating manakin for you to practice.
 
=====SUGGESTED WORKFLOW FOR AIRWAY BOX=====
 
*Remember to put what you need inside the box before intubating:
 
** BVM with HEPA filter, suction, vent tubing, glidescope, tube, tape to secure tube.
 
* You have the option of draping the other end (extra drapes available on the counter along with tape)
 
* After securing tube, attache the viral filter/BVM OR continuous capnometry if you have that set up.
 
* Remove the box from the patient and leave it in the room for at least 30 minutes over sink (to allow aerosols to clear) then retrieve for cleaning.
 
[[File:box sink.jpg|100px]]
 
* Sterilize after use with germicidal wipes thoroughly and allow it to dry.
 
** Buddy can clean this along with glidescope. Should wear full PPE.
 
 
 
===AIRWAY GENERAL INFORMATION===
 
* '''Treat All Intubations as PUIs:'''
 
** It is up to your discretion if you want to PAPR vs N95
 
*** Please wear the recommended level of PPE GLA ID recommends for aerosolizing procedures.
 
** Please remember to document your PPE in CPRS note.
 
** In CPRS write an "Intubation Note" or "Emergency Physician Airway Response Note" (if no intubation performed)
 
  
 
==Other WLA VA Pages==
 
==Other WLA VA Pages==

Latest revision as of 03:35, 25 May 2020

Last Updated: 5/24/20

COVID AIRWAY INTUBATIONS

AIRWAY SUPPLIES

  • Airway carts are located across charge nurse station. These have PAPR, PPE, and airway equipment including viral filters.
  • Code is 1212
  • In an airway emergency - grab cart, new Red Airway Box from Med room, Aerosol Box
  • Glidescope Go Blades:
    • We are running low on the S4 blades (larger blades).
    • Please consider using the S3 blades instead as it is unclear when we will receive a resupply of this.
    • Jonie has some in her office if needed to safeguard them from being stolen.
  • PAPR, belt, tube, and hood are REUSABLE only the plastic cover over breathing tube is disposable.
  • Clean PAPR hoods thoroughly with sani-wipes when doffing to decease pathogens.
  • PAPRs and the Paprs hoods will be cleaned by SPS so after you are done using it, place in a biohazard bag and leave it in the dirty Utility room of the actual Unit where you intubated.
    • Contact SPS M-F 41811, Weekends 310-987-8710 or 323-497-4585. They will pick up, clean and deliver back to ED.

BASIC TECHNIQUE TO TEMPORARILY SECURING AN ET TUBE

SECURING AN ET TUBE WHILE USING AN AIRWAY BOX

DEMONSTRATION OF USING A PONCHO WHILE INTUBATING

Other WLA VA Pages