PRE-INTUBATION
- laryngoscope check
- CONSIDER VL As 1ST OPTION?
- ett, syringe & tie
- bougie/stylet
- lma/IGEL
- VENTILATOR CIRCUIT SET UP (1+2)
- CAPNOGRAPHY working
- SUCTION working
- PATIENT POSITION
- IV ACCESS CHECKED
- PLAN DRUG DOSES
INTUBATION
PRE-OX VIA C-CIRCUIT (1)
AIM FOR BEST ETO2 OR 3-5MINS PREOX
GIVE DRUGS
AVOID BAGGING IF POSSIBLE (AEROSOL)
INTUBATE - CONSIDER VL 1ST?
LMA/IGEL
STOP - CAN YOU VENTILATE?
IF YES, CONSIDER DISPOSABLE FIBRESCOPE AND EXCHANGE CATHETER
DECLARE CICV
DECLARE FRONT OF NECK ACCESS
SCALPEL, BOUGIE, SIZE #6 ETT
PLAN A
PLAN B
PLAN 'D'
FAIL
FAIL
propofology.com
EDUCATION IN CRITICAL CARE
- TRUST-GUIDED PPE
- ASSISTANT/2ND INTUBATOR
- CLARIFY ROLES
post-intubation
in-room INTUBATION checklist for suspected #covid19 patient
SUCCESS
ATTACH TO C-CIRCUIT + FILTER (1)
STOP
CHECK CAPNOGRAPH + CHEST MOVEMENT
SECURE ETT
CHANGE TO OXYLOG?
100% O2
CLAMP TUBE
DISCONNECT C-CIRCUIT (1)
CONNECT TO VENTILATOR CIRCUIT (2)
UNCLAMP TUBE + VENTILATE
INSERT NG TUBE
TRANSFER?
CHECK CANNULAE
SEDATION OPTIMISED
CHECK 'GOOD TO GO' FROM OUTSIDE THE ROOM
O2 SUPPLY AND CONNECT
COVER PATIENT WITH CLEAR PLASTIC SHEET
CHANGE TO ICU VENTILATOR
STOP OXYLOG
CLAMP TUBE
TRANSFER FILTER AND THE CAPNOGRAPH TO VENT
ATTACH INLINE SUCTION
ATTACH VENTILATOR
UNCLAMP TUBE
CHECK VENTILATION
FULL DEBRIEF
COMPLETE ADMISSION HANDOVER
REMOVE PPE CAREFULLY
COMPLETE OUTSIDE CHECKLIST
DR. DAVID LYNESS (Intensive Care society, UK)
DR. JONNY WILKINSON (Northampton general icu)
& MIDLANDS CORONAVIRUS ICU GROUP
@gas_craic
@wilkinsonjonny
stop and recheck then go
CIRCUIT ONE
CIRCUIT TWO
traditional plan c left out due to aerosol risks - confirm your department policy
THIS HAS BEEN DESIGNED AS A GUIDE AND MAY NOT SUIT YOUR LOCAL NEEDS OR RESOURCES