Difference between revisions of "WLAVA:COVID19 ED Airway"

(SUGGESTED WORKFLOW FOR AIRWAY BOX)
(SUGGESTED WORKFLOW FOR AIRWAY BOX)
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* After securing tube, attache the viral filter/BVM OR continuous capnometry if you have that set up.
 
* 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.
 
* 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]]♦♦♦♦
+
[[File:box sink.jpg|100px]]
 
* Sterilize after use with germicidal wipes thoroughly and allow it to dry.  
 
* Sterilize after use with germicidal wipes thoroughly and allow it to dry.  
 
** Buddy can clean this along with glidescope. Should wear full PPE.
 
** Buddy can clean this along with glidescope. Should wear full PPE.

Revision as of 02:37, 23 April 2020

Last Updated: 4/9/20

COVID Airway Intubation

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.

3rd Overnight Weekday 11p-7a and Weekend 7p-7a (COVID-19) Attending Duties

  • Airway management for crash COVID patients.
  • 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.

Clipboard.jpg COVID Airway Item Checklist

AIRWAY RED BOX IN MED ROOM

  • Stored in Med Room
  • Check Daily (3 essential items)
    • Glidescope Go (CHECK BATTERY)
    • Grab and Go Bag (premade ones in Yellow Duffel Bag)
    • COVID Medication Bag

Red box.jpg

AEROSOL (ACRYLIC/PLEXIGLASS) BOX

  • Stored in the Doctor's station.
  • 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.

Box sink.jpg

  • 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)

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