| Abstract [eng] |
The 2019 outbreak of coronavirus disease 2019 in Wuhan, China, led to a global pandemic, catching the world off guard, including medical professionals. Soon it was identified that physicians performing endotracheal intubations were at the one of the greatest risks of pathogen transmission. To minimize viral spread, healthcare providers had to adapt existing airway management protocols based on new evidence. Reviewing the literature, it became evident that COVID-19 patients without respiratory failure required intubations to be performed in dedicated negative pressure rooms by experienced anaesthesiologists wearing special personal protective equipment, including respirators with at least FFP3 filtration capacity. A dedicated COVID-19 trolley, similar to a difficult airway trolley, equipped with disposable instruments and equipment, was recommended. Preoxygenation for at least 5 minutes using a sealed face mask was routine, while nasal oxygen therapy was avoided due to the high risk of viral transmission. A modified rapid induction approach using regular medications was advised, with videolaryngoscopy employed for intubation. In cases of airway difficulties, established protocols were followed, with priority given to supraglottic devices. During extubation, a special technique was used exclusively for fully awake patients, who were transported directly to dedicated wards, bypassing the recovery ward. As the relevance of COVID-19 has decreased, it is worth noting that the adaptations made to existing airway management protocols during the pandemic may remain relevant for managing other infectious diseases in the future. These protocols, focused on minimizing viral transmission and ensuring the safety of healthcare providers, could serve as a valuable resource in similar situations going forward. |
