COVID-19 Intubation Checklist
Personal protective equipment (PPE)
• Standard PPE
• N95 or PAPR.
• Facemask +/- googles
• Gloves, gown.
• Consider also (depending on availability):
• Hood to cover neck (if unavailable, disposable cap to cover hair).
• Two pairs of gloves, under-layer ideally long-cuffed surgical gloves.
• Bunny suit for complete body coverage.
Medications & pre-planned ETT depth
• High dose paralytic (e.g. Rocuronium at least 1.2 mg/kg).
• Calculate optimal ETT depth (using MDCalc).
• Video Laryngoscope & Blade
• BVM with PEEP valve & viral filter.
• Additional viral filter on exhalation port of ventilator.
• Most experienced staff, limit people in room.
• Pre-oxygenation: Options may include:
• BiPÅP with a two-tube system & viral filter.
• BVM with viral filter, PEEP valve, and nasal cannula.
• During apnea:
• If using BiPÅP: Continue with backup rate.
• If using BVM: Hold mask (with PEEP valve) on patient's mouth to prevent decruitment (but don't actively bag the patient).
• Inflate ETT cuff prior to ventilation.
• Secure ETT at pre-calculated depth.
• Meticulous removal of PPE (use ethanol hand wash before and after removal of PPE).
Dr. Josh Farkas @pulmcrit via Internet Book of Critical Care @iBookCC
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