RT Journal Article
SR Electronic
T1 Intubation Checklist for COVID-19 Patients: A Practical Tool for Bedside Practitioners
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.08063
DO 10.4187/respcare.08063
A1 Alfred Papali
A1 Anna O Ingram
A1 Amy M Rosenberger
A1 Frances R D’Arcy
A1 Jaspal Singh
A1 Lisa Ahlberg
A1 Christopher D Russell
YR 2020
UL http://rc.rcjournal.com/content/early/2020/08/11/respcare.08063.abstract
AB 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.