Table 2.

Summary of airway management guidelines for COVID-19 (see main text for full details) [1, 15–25]

	Australia/New Zealand [22]	Canada [16, 17]	China [19, 24]	India [20]	Italy [23]	Korea [15]	Singapore [18]	UK [25]	US [1]	International consensus [21]
Personal protective equipment Donning/Doffing	N95, gown, eye protection, face shield, gloves Double gloves for airway management	N95, gown, eye shield, hood/hat, gloves (PAPR controversial) Double gloves for airway management	N95/PAPR, gown, goggles/face shield, hood Double gloves for airway management	N95, gown, eye shield, cap, shoe covers Double gloves	N95, gown, face shield/goggles, loves, shoe covers Double gloves for airway management	N95/PAPR, gown, face shield/goggles, shoe covers Double gloves	N95, gown, eye protection, PAPR Double gloves considered	Full personal protective equipment Double gloves for intubation	N95/PAPR, gown, goggles/face shield, cap Double gloves for intubation	N95/PAPR, goggles, gown, hood/face shield, shoe covers Double gloves for intubation
	Buddy system	–	Buddy system	–	Buddy system	–	–	Buddy system	–	Buddy system
Operating theatre	Designated area, negative pressure room	Isolation/negative pressure room	Designated area, negative pressure room	Designated area	Designated area, negative pressure room	Negative pressure room	Isolation/negative pressure room	Negative pressure room	Designated area, negative pressure room	–
Communication	Pre-briefing; cognitive aids, checklist	–	–	–	Team briefing; cognitive aids, checklist	–	Team briefing; coordinator	Team briefing; cognitive aids, checklist	Team briefing	–
Airway manager	Most skilled/experience	Most skilled	Experienced, assisted by 2nd clinician	Experienced	Most skilled and experienced	Most experienced	Most experienced	Most appropriate	Most experienced	Most skilled 2nd operator assisting
Personnel	Limit numbers	Limit numbers	Limit numbers	Limit numbers	Limit numbers	–	Limit numbers	Limit numbers	Limit numbers	–
Preoxygenation	100% oxygen for 5 min No HFNO	100% oxygen for 5 min	100% oxygen for 5 min If HFNO, cover nose and mouth with wet gauze	100% oxygen for 5 min Cover patient’s nose and mouth with wet gauze	100% oxygen for ≥ 3 min Apneic O2 low flow	100% oxygen for 5 min No HFNO	Well-fitting mask Avoid non-invasive ventilation and HFNO	100% oxygen for ≥ 3 min, well-fitting mask No HFNO	100% oxygen for 5 min	100% oxygen for 5 min
Position	45° head up	–	Ramping in obese	–	–	–	–	Ramping in obese	–	Head up
Drugs	Succinylcholine or rocuronium	Rocuronium	Succinylcholine or rocuronium	Succinylcholine	Succinylcholine or rocuronium	–	–	Succinylcholine or rocuronium	Rocuronium	Rocuronium
Induction	Rapid sequence induction; consider cricoid pressure carefully	Rapid sequence induction ± cricoid pressure	Rapid sequence induction	Rapid sequence induction	Rapid sequence induction; consider cricoid pressure carefully	Rapid sequence induction with cricoid pressure	Rapid sequence induction	Rapid sequence induction	Rapid sequence induction with cricoid pressure	Modified rapid sequence induction
Tracheal intubation	Video laryngoscope	Consider video laryngoscope	Video laryngoscope/bronchoscope	Video laryngoscope	Video laryngoscope	Consider video laryngoscope	Video laryngoscope	Video laryngoscope	Video laryngoscope	Video laryngoscope
Supraglottic airways	Intubation preferable to SGA. SGA preferable to FMV Use 2nd generation –	Intubation preferable to SGA. SGA preferable to FMV – For airway rescue	– Use 2nd generation For airway rescue	– – For airway rescue	– Use 2nd generation For airway rescue	SGA preferred to FMV – –	Intubation preferred to SGA – –	SGA preferred to FMV Use 2nd generation For airway rescue	SGA preferred to FMV – –	Should be available – –
Face mask ventilation	Minimize ventilation pressures	If indicated, small tidal volumes	As backup option	Avoid	If indicated, small tidal volumes	If indicated, small tidal volumes	If indicated, small tidal volumes	If indicated	If indicated, small tidal volumes	Mask ventilation after induction
Front of neck access	Scalpel-bougie Avoid concurrent positive pressure ventilation from above	–	Surgical or percutaneous cricothyroidotomy	–	Surgical or percutaneous cricothyroidotomy preferred Awake tracheostomy under local anesthesia	–	–	Surgical cricothyroidotomy preferred Needle cricothyroidotomy may be appropriate	–	–
Awake intubation	–	Avoid flexible bronchoscopic intubation; consider video laryngoscope Beware inadequate sedation	Adequate sedation and topicalization; nasal route preferred Consider endoscopic mask with flexible bronchoscope	Avoid	If indicated Video laryngoscope faster than flexible bronchoscopy	If indicated	Avoid	Flexible bronchoscopy techniques unlikely to be first choice	If indicated	If indicated
Extubation	Minimize coughing: local anesthesia, dexmedetomidine, opioids Oxygen mask	–	Two layers of wet gauze to cover the patient’s nose and mouth	Prophylactic antiemetics	–	–	Antiemetics Nasal prong and surgical mask over	Minimize coughing: local anesthesia, dexmedetomidine, opioids Nasal prong and surgical mask over	Prophylactic antiemetics Minimize coughing: local anesthesia, dexmedetomidine, opioids	–

FMV: face mask ventilation; HFNO: high flow nasal oxygen; PAPR: powered air purifying respirators; SGA: supraglottic airway device; –: refers to no statement from respective guidelines