Table 6.

Anesthesia considerations

Limiting the number of OR personnel in the room during intubation is advisable

Patients intubated in OR should have limited bagging, favoring Rapid Sequence Intubation (RSI)

Avoidance of awake intubation is recommended

Double gloves for intubation should be used routinely and the top layer removed following intubation to limit further contamination

Single attempt intubation should be sought

Endotracheal intubations should be performed by the most experienced individual in the OR setting. The practice of allowing junior residents and trainees to intubate patients in the COVID-19 OR is highly discouraged as multiple attempts to intubation increase the risk of unnecessary exposure of health care providers in the room

Bag Valve Mask (BVM) ventilation prior to intubation should be discouraged. If at all needed, use appropriate filters attached to the mask and secure the mask to the patient’s face to avoid leaks and aerosolization

Video Laryngoscopy is preferred over Direct Laryngoscopy, when available

Fiberoptic intubation should be limited and avoided if possible

Disposable equipment should be used where applicable

The endotracheal tube cuff should be inflated before initiating mechanical ventilation

Closed suction systems should be used for airway aspiration and suctioning