Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID‐19 adult patient group

Introduction This statement was planned on 11 March 2020 to provide clinical guidance and aid staff preparation for the coronavirus disease 2019 (COVID‐19) pandemic in Australia and New Zealand. It has been widely endorsed by relevant specialty colleges and societies. Main recommendations Generic gu...

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Bibliographic Details
Published in:	Medical journal of Australia Vol. 212; no. 10; pp. 472 - 481
Main Authors:	Brewster, David J, Chrimes, Nicholas, Do, Thy BT, Fraser, Kirstin, Groombridge, Christopher J, Higgs, Andy, Humar, Matthew J, Leeuwenburg, Timothy J, McGloughlin, Steven, Newman, Fiona G, Nickson, Chris P, Rehak, Adam, Vokes, David, Gatward, Jonathan J
Format:	Journal Article
Language:	English
Published:	Australia John Wiley and Sons Inc 01-06-2020
Subjects:	Adult Airway Management - methods Airway Management - standards Anesthesia, Analgesia and Pain Australia Betacoronavirus Consensus Consensus Statements Coronavirus Infections - epidemiology Coronavirus Infections - therapy COVID-19 Emergency Medicine Female Humans Infection Control - methods Infection Control - standards Infectious Diseases Intensive care Intubation, Intratracheal - methods Intubation, Intratracheal - standards Male New Zealand Pandemics Pneumonia, viral Pneumonia, Viral - epidemiology Pneumonia, Viral - therapy Practice Guidelines as Topic Research and Reviews Respiratory tract infections SARS-CoV-2 New Zealand Australia COVID-19 Respiratory tract infections Intensive care Infectious diseases Pneumonia, viral
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Summary:	Introduction This statement was planned on 11 March 2020 to provide clinical guidance and aid staff preparation for the coronavirus disease 2019 (COVID‐19) pandemic in Australia and New Zealand. It has been widely endorsed by relevant specialty colleges and societies. Main recommendations Generic guidelines exist for the intubation of different patient groups, as do resources to facilitate airway rescue and transition to the “can't intubate, can't oxygenate” scenario. They should be followed where they do not contradict our specific recommendations for the COVID‐19 patient group. Consideration should be given to using a checklist that has been specifically modified for the COVID‐19 patient group. Early intubation should be considered to prevent the additional risk to staff of emergency intubation and to avoid prolonged use of high flow nasal oxygen or non‐invasive ventilation. Significant institutional preparation is required to optimise staff and patient safety in preparing for the airway management of the COVID‐19 patient group. The principles for airway management should be the same for all patients with COVID‐19 (asymptomatic, mild or critically unwell). Safe, simple, familiar, reliable and robust practices should be adopted for all episodes of airway management for patients with COVID‐19. Changes in management as a result of this statement Airway clinicians in Australia and New Zealand should now already be involved in regular intensive training for the airway management of the COVID‐19 patient group. This training should focus on the principles of early intervention, meticulous planning, vigilant infection control, efficient processes, clear communication and standardised practice.
Bibliography:	on 16 March 2020. mja.com.au The unedited version of this article was published as a preprint on ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 The unedited version of this article was published as a preprint on http://mja.com.au on 16 March 2020.
ISSN:	0025-729X 1326-5377
DOI:	10.5694/mja2.50598