16.04.2020

Pediatric Airway Management in COVID-19 patients - Consensus Guidelines from the Society for Pediatric Anesthesia's Pediatric Difficult Intubation Collaborative and the Canadian Pediatric Anesthesia Society

Therapeutic PaediatricsAnesthesia-intensive care
Matava CT et al
Anesth Analg

Main result

Need for PPE simulation in situ, protecting practitioners at risk (teleworking, administrative), PPE for any child coming from a high-risk area (cf asymptomatic), cognitive aid checklist type, preparation of material prior to OR management, preoperative anxiolysis, IV induction with modified rapid sequence induction, lowest possible positive pressure before intubation, avoid bagging, plastic screen under the intuber's arm to protect him, minimize laryngoscopy time, supraglottic device seems acceptable, filter on the expi circuit, PPE for the practitioner, minimize cough on extubation, same precautions for transporting a patient, negative ambient pressure and avoid connected ventilation systems, difficult orotracheal intubation: videolaryngoscopy, fibro.

Takeaways

Anxiolytic medication prior to induction, IV induction, intubation tubes with cuff, use of videolaryngoscope, closed endotracheal suction system, PPE, negative pressure in the room, cleaning time to be observed

Strength of evidence Weak

Expert opinion based on current literature

Objectives

Recommendations, staff protection for pediatric airway management of COVID-19 patients.

Method

Members of working group on intubation (USA/Canada) published guidelines based on expert opinion (44 anaesthetists, 1 ENT) + literature review.

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