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.

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.

Matava CT; Kovatsis PG; Lee JK; Castro P; Denning S; Yu J; Park R; Lockman JL; Von Ungern-Sternberg B; Sabato S; Lee LK; Ayad I; Mireles S; Lardner D; Whyte S; Szolnoki J; Jagannathan N; Thompson N; Stein ML; Dalesio N; Greenberg R; McCloskey J; Peyton J; Evans F; Haydar B; Reynolds P; Chiao F; Taicher B; Templeton T; Bhalla T; Raman VT; Garcia-Marcinkiewicz A; Gálvez J; Tan J; Rehman M; Crockett C; Olomu P; Szmuk P; Glover C; Matuszczak M; Galvez I; Hunyady A; Polaner D; Gooden C; Hsu G; Gumaney H; Pérez-Pradilla C; Kiss EE; Theroux MC; Lau J; Asaf S; Ingelmo P; Engelhardt T; Hervías M; Greenwood E; Javia L; Disma N; Yaster M; Fiadjoe JE

Anesthesia and Analgesia

2020

2020-07

The severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) pandemic has challenged medical systems and clinicians globally to unforeseen levels. Rapid spread of COVID-19 has forced clinicians to care for patients with a highly contagious disease without evidence-based guidelines. Using a virtual modified nominal group technique, the Pediatric Difficult Intubation Collaborative (PeDI-C), which currently includes 35 hospitals from 6 countries, generated consensus guidelines on airway management in pediatric anesthesia based on expert opinion and early data about the disease. PeDI-C identified overarching goals during care, including minimizing aerosolized respiratory secretions, minimizing the number of clinicians in contact with a patient, and recognizing that undiagnosed asymptomatic patients may shed the virus and infect health care workers. Recommendations include administering anxiolytic medications, intravenous anesthetic inductions, tracheal intubation using video laryngoscopes and cuffed tracheal tubes, use of in-line suction catheters, and modifying workflow to recover patients from anesthesia in the operating room. Importantly, PeDI-C recommends that anesthesiologists consider using appropriate personal protective equipment when performing aerosol-generating medical procedures in asymptomatic children, in addition to known or suspected children with COVID-19. Airway procedures should be done in negative pressure rooms when available. Adequate time should be allowed for operating room cleaning and air filtration between surgical cases. Research using rigorous study designs is urgently needed to inform safe practices during the

Adolescent; Humans; Child; Preschool; Infant; Newborn; Guidelines as Topic; Pneumonia; Intubation; Infection Control; Infectious Disease Transmission; Consensus; Pandemics; Airway Management/ methods; Anesthesia/methods; Anesthesiology/ methods/standards; Coronavirus Infections/ therapy; Pediatrics/ methods/standards; Intratracheal/ methods/standards; Patient-to-Professional/prevention & control; Viral/ therapy

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NEOMED College of Medicine

Department of General Surgery

July 2020 List