WLAVA:COVID19 ED Airway: Difference between revisions
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** Please remember to document your PPE in CPRS note. | ** 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) | ** In CPRS write an "Intubation Note" or "Emergency Physician Airway Response Note" (if no intubation performed) | ||
===BASIC TECHNIQUE TO TEMPORARILY SECURING AN ET TUBE=== | |||
{{#widget:YouTube|id=dMARECkwt7s}} | |||
===SECURING AN ET TUBE WHILE USING AN AIRWAY BOX=== | |||
{{#widget:YouTube|id=_CBRZfse9Hs}} | |||
===DEMONSTRATION OF USING A PONCHO WHILE INTUBATING=== | |||
{{#widget:YouTube|id=JP7V6pb9new}} | |||
==Other WLA VA Pages== | ==Other WLA VA Pages== |
Revision as of 15:50, 23 April 2020
Last Updated: 4/9/20
COVID Airway Intubation
- Reference document:
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.
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
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.
- 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)
- It is up to your discretion if you want to PAPR vs N95
BASIC TECHNIQUE TO TEMPORARILY SECURING AN ET TUBE
{{#widget:YouTube|id=dMARECkwt7s}}
SECURING AN ET TUBE WHILE USING AN AIRWAY BOX
{{#widget:YouTube|id=_CBRZfse9Hs}}
DEMONSTRATION OF USING A PONCHO WHILE INTUBATING
{{#widget:YouTube|id=JP7V6pb9new}}
Other WLA VA Pages
- WLAVA: COVID19 ED Operational Updates
- WLAVA: Enhanced Screening Tent
- EST Provider Orientation
- WLA VA PPE Main Information Page
- WLAVA:Enhanced Screening Tent Telehealth