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Research ArticleSpecial Article

Intubation Checklist for COVID-19 Patients: A Practical Tool for Bedside Practitioners

Alfred Papali, Anna O Ingram, Amy M Rosenberger, Frances R D'Arcy, Jaspal Singh, Lisa Ahlberg and Christopher D Russell
Respiratory Care January 2021, 66 (1) 138-143; DOI: https://doi.org/10.4187/respcare.08063
Alfred Papali
Division of Pulmonary & Critical Care Medicine, Atrium Health, Charlotte, North Carolina.
Division of Pulmonary, Critical Care and Sleep Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
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  • For correspondence: [email protected]
Anna O Ingram
Critical Care Nursing, Atrium Health, Charlotte, North Carolina.
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Amy M Rosenberger
Critical Care Nursing, Atrium Health, Charlotte, North Carolina.
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Frances R D'Arcy
Critical Care Nursing, Atrium Health, Charlotte, North Carolina.
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Jaspal Singh
Division of Pulmonary & Critical Care Medicine, Atrium Health, Charlotte, North Carolina.
Levine Cancer Institute, Atrium Health, Charlotte, North Carolina.
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Lisa Ahlberg
Division of Pulmonary & Critical Care Medicine, Atrium Health, Charlotte, North Carolina.
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Christopher D Russell
Division of Pulmonary & Critical Care Medicine, Atrium Health, Charlotte, North Carolina.
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Abstract

BACKGROUND: The high frequency of aerosolizing procedures in the ICU, including endotracheal intubation, places clinical staff at elevated risk of contracting the 2019 coronavirus (COVID-19). Use of an intubation checklist can reduce exposure risk and thus acts as a potential safeguard. Specific, step-by-step guidance to perform safe endotracheal intubation in the setting of COVID-19 are limited. This article outlines the development and refinement of a COVID-19 intubation checklist and operational protocol for ICU staff at a single center in the United States.

METHODS: A standard pre-intubation checklist was adapted and refined by consensus using a multidisciplinary and iterative process, then distributed to local staff for clinical use. Subsequent mock intubation training sessions were held using the new checklist to ensure proficiency. Planned debriefing sessions helped identify several previously unanticipated issues, allowing for further refinement of the intubation checklist and inclusion of all stakeholders.

RESULTS: A COVID-19 intubation checklist helped optimize safety during a high-risk situation by minimizing aerosolization of secretions, the number of staff required in the room, the time spent in the room, and the frequency of donning/doffing personal protective equipment.

CONCLUSIONS: We present a checklist for use during high-risk intubations of COVID-19 patients, which serves as a pragmatic bedside tool for clinicians. The process of checklist development may also serve as a model for facilities preparing their own pandemic protocols.

  • intubation
  • COVID
  • pandemic
  • checklist
  • ICU
  • safety
  • protocol
  • quality improvement

Footnotes

  • Correspondence: Alfred Papali MD, Atrium Health Pineville Hospital 10650 Park Road, Suite 300, Charlotte, NC 28210. E-mail: alfred.papali{at}atriumhealth.org
  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • Dr Singh has disclosed relationships with Medtronic, and Somnoware Sleep Solutions. All other authors have disclosed no conflicts of interest.

  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care: 66 (1)
Respiratory Care
Vol. 66, Issue 1
1 Jan 2021
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Intubation Checklist for COVID-19 Patients: A Practical Tool for Bedside Practitioners
Alfred Papali, Anna O Ingram, Amy M Rosenberger, Frances R D'Arcy, Jaspal Singh, Lisa Ahlberg, Christopher D Russell
Respiratory Care Jan 2021, 66 (1) 138-143; DOI: 10.4187/respcare.08063

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Intubation Checklist for COVID-19 Patients: A Practical Tool for Bedside Practitioners
Alfred Papali, Anna O Ingram, Amy M Rosenberger, Frances R D'Arcy, Jaspal Singh, Lisa Ahlberg, Christopher D Russell
Respiratory Care Jan 2021, 66 (1) 138-143; DOI: 10.4187/respcare.08063
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Keywords

  • intubation
  • COVID
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  • checklist
  • ICU
  • safety
  • protocol
  • quality improvement

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