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Covid 19 Intubation – Proposed steps to minimise aerosol generationDrug boxes to be stored in fridge (daily check by designated member of team – allocated at morning brief)PropofolRocuroniumSuxamethoniumMetaraminolEphedrineKit ListTo take into the room (if not already in the room):Water CircuitFace maskFilter (HME) End tidal CO2 sensor and blockCorrectly sized ET tubeLubricating Gel20ml SyringeMcGrath and correctly sized bladeBougieOral airwayAnchor fast (tube tie)Suction tubingVentilator tubingInco padPillowDrugs (labelled and drawn up)Saline flushes To have outside the room:Airway trolley - including kit for front of neck accessI-gelMac blade and handleOther ET tubes (size 6, 7 and 8mm)ScissorsMcgills forcepsEmergency drug boxDon’t cut ETT– leave space to be able to apply clamp if neededAim to use videolaryngoscopePrepare waters circuit and closed suction as below:Preoxygenate with PEEPAdminister drugs, RSI, avoid bagging if possibleWhen you remove mask from patient, disconnect kit as shown:IntubateNo ventilation till cuff upOnce cuff up connect closed suction as shown:Then circuit and vent (don’t check ventilate with waters circuit):Then turn on ventilation and confirm CO2/chest rise and fallIf disconnecting to, for example, connect to oxylog:Pause ventilatorClamp ETT with blue clamp and gauze (to reduce risk of damage to ETT)Disconnect distal to CO2 a reapply red cap to vent tubing ................
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