Open Medicine Journal




ISSN: 1874-2203 ― Volume 7, 2020
RESEARCH ARTICLE

Grab and Go COVID-19 Intubation Kit and Emergency Medication Kit



Vladislav Mansurov1, Beena Yousuf1, *, Kandela Swancy Sujatha1, Huda Alfoudri1
1 Department of Anesthesia and Critical Care and Pain Management, Al Adan Hospital, Ministry of Health, Hadiya, Kuwait, UAE


Article Information


Identifiers and Pagination:

Year: 2020
Volume: 7
First Page: 23
Last Page: 24
Publisher Id: MEDJ-7-23
DOI: 10.2174/1874220302007010023

Article History:

Electronic publication date: 20/08/2020
Collection year: 2020

© 2020 Mansurov et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Department of Anesthesia and Critical Care and Pain Management, Al Adan Hospital, Ministry of Health, Hadiya, Kuwait, UAE; Tel: 0096597436008; E-mail: beena_yousuf@hotmail.com





The current COVID-19 pandemic is an unprecedented global crisis that renewed focus on public health and affected families, communities, and societies across the world [1World Health Organization. Covid-19 Strategy Update 2020. Available at https://www.who.int/publications/i/item /covid-19-strategy-update]. While HCWs (health care workers) safety concerns grow, physicians are gaining exceptional experience in the management of critically ill patients. Undoubtedly, one of the most stressful and substantial points in patient care is airway management [2Cook TM, Boghdadly KEl, McGuire B, McNarry AF, Patel A, Higgs A. Consensus guidelines for managing the airway in patients with covid-19 guidelines from the difficult airway society, the association of anaesthetists the intensive care society, the faculty of intensive care medicine and the royal college of anaesthetists.Anaesthesia 2020; 75(6): 785-99.]. Intubation is one of the highest risk moment for COVID-19 spread to HCWs and other patients [3Cheung JC, Ho LT, Cheng JV, Cham EY, Lam KN. Staff safety during emergency airway management for COVID-19 in Hong Kong. Lancet Respir Med 2020 Apr; 8(4): e19., 4Dawei Wang MD, Bo Hu MD, Chang Hu MD, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in wuhan, china Journal of the American Medical Association 2020; 323(11): 1061-9.]. Despite planning ahead for intubation, it is not uncommon to have a crashing patient who needs immediate airway support. It is frequently observed that in emergencies adhering to recommendations may not always be possible, especially when one has to concentrate on many tasks like gearing up with PPEs, minimizing infection spread, and preparing and planning of required equipment and drugs [5Edward Livingston MD, Angel Desai MD, MPH, Michael Berkwits MD, MSCE, et al. Sourcing personal protective equipment during the covid-19 pandemic. JAMA 2020.]. In emergency scenarios, time is the key. Ideally, neither the patient nor the HCWs should be exposed to higher risks, regardless of the location of the scenarios, especially dealing with non-critical care staff in remote areas. COVID-19 is a highly contagious disease and dealing with COVID emergencies is an extremely stressful situation for HCWs, so it is useful to provide pre-defined protocols, simulation drills as well as easily accessible, disposable, ready to use equipment [6Pan L, Wang L, Huang X. How to face the novel coronavirus infection during the 2019-2020 epidemic: the experience of Sichuan Provincial People"s Hospital. Intensive Care Med 2020; 46(4): 573-5.
[http://dx.doi.org/10.1007/s00134-020-05964-0] [PMID: 32072300]
, 7Jianbo Lai MSc, Simeng Ma, MSc, Ying Wang MSc, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease. JAMA Netw Open 2020; 3(3): e203976.].

While preparing for COVID-19 surge, the Department of Anesthesia, Critical care and pain management, Al-Adan hospital in Kuwait, developed COVID-19 related local polices, protocol and guidelines. With our experience of managing suspected and confirmed COVID-19 patients, we had noticed that the intubation team has so many critical tasks to perform before airway management like gathering the team, getting ready with PPE, preparing patient's medications and equipment which is time-consuming especially when dealing in non-critical care areas. To minimize the task for the intubation team and allow them adequate time for PPE donning, we came up with an idea of using a pre-prepared basic intubation kit (Fig. 1) and an emergency medication kit (Fig. 2). These kits are compact and convenient to use. The contents are sealed in clear transparent pouches. A colored easily recognizable labeled sticker along with the contents list is attached to the bag. There is no need to contaminate all the airway or medication trolleys just grab and go. In this global crisis, we hope our suggestions will help others in optimizing safety practices in COVID airway emergencies.

Fig. (1)
COVID Emergency medication kit with the content list.
One each of the following medications: pre-filled Adrenaline syringe, Adrenaline ampoule, pre-filled Atropine syringe, Atropine ampoule, Ephedrine ampoule, Ketamine 500 mg, Propofol 200 mg, Rocuronium 50 mg. Other items with quantities: Prefilled Flush syringe (2), water for injections 10 ml (2), needles 18G (2), syringes 5 ml (4), syringes 10 ml (4), alcohol swabs (2), cannula 18 and 20 G (one each), Tegaderm (2), and extension line (1).


Fig. (2)
COVID intubation kit with the content list.
Endotracheal tubes size 7.0/7.5/8.0/8.5 one each, Oropharyngeal airway sizes 4,5 one each, one tube tie, lubricant, one scalpel, one HME filter, disposable laryngoscope sizes 3 and 4 one each, one 10 ml syringe, and one bougie.


CONFLICT OF INTEREST

The authors declare no conflict of interest, financial or otherwise.

REFERENCES

[1] World Health Organization. Covid-19 Strategy Update 2020. Available at https://www.who.int/publications/i/item /covid-19-strategy-update
[2] Cook TM, Boghdadly KEl, McGuire B, McNarry AF, Patel A, Higgs A. Consensus guidelines for managing the airway in patients with covid-19 guidelines from the difficult airway society, the association of anaesthetists the intensive care society, the faculty of intensive care medicine and the royal college of anaesthetists.Anaesthesia 2020; 75(6): 785-99.
[3] Cheung JC, Ho LT, Cheng JV, Cham EY, Lam KN. Staff safety during emergency airway management for COVID-19 in Hong Kong. Lancet Respir Med 2020 Apr; 8(4): e19.
[4] Dawei Wang MD, Bo Hu MD, Chang Hu MD, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in wuhan, china Journal of the American Medical Association 2020; 323(11): 1061-9.
[5] Edward Livingston MD, Angel Desai MD, MPH, Michael Berkwits MD, MSCE, et al. Sourcing personal protective equipment during the covid-19 pandemic. JAMA 2020.
[6] Pan L, Wang L, Huang X. How to face the novel coronavirus infection during the 2019-2020 epidemic: the experience of Sichuan Provincial People"s Hospital. Intensive Care Med 2020; 46(4): 573-5.
[http://dx.doi.org/10.1007/s00134-020-05964-0] [PMID: 32072300]
[7] Jianbo Lai MSc, Simeng Ma, MSc, Ying Wang MSc, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease. JAMA Netw Open 2020; 3(3): e203976.
Track Your Manuscript:


Endorsements



"Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines."


Daniel Pesut
(Indiana University School of Nursing, USA)

"It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor."


Jacques Descotes
(Centre Antipoison-Centre de Pharmacovigilance, France)

"Publishing research articles is the key for future scientific progress. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community."


Patrice Talaga
(UCB S.A., Belgium)

"Open access journals are a novel concept in the medical literature. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. They are an outstanding source of medical and scientific information."


Jeffrey M. Weinberg
(St. Luke's-Roosevelt Hospital Center, USA)

"Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Indeed, the research articles span a wide range of area and of high quality. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals."


Debomoy K. Lahiri
(Indiana University School of Medicine, USA)

"Open access journals represent a major break-through in publishing. They provide easy access to the latest research on a wide variety of issues. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Articles are of uniformly high quality and written by the world's leading authorities."


Robert Looney
(Naval Postgraduate School, USA)

"Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets."


Richard Reithinger
(Westat, USA)

"Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers."


J. Ferwerda
(University of Oxford, UK)

"Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content."


Sean L. Kitson
(Almac Sciences, Northern Ireland)

"In principle, all scientific journals should have open access, as should be science itself. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. The articles are high standard and cover a wide area."


Hubert Wolterbeek
(Delft University of Technology, The Netherlands)

"The widest possible diffusion of information is critical for the advancement of science. In this perspective, open access journals are instrumental in fostering researches and achievements."


Alessandro Laviano
(Sapienza - University of Rome, Italy)

"Open access journals are very useful for all scientists as they can have quick information in the different fields of science."


Philippe Hernigou
(Paris University, France)

"There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Open access journals offer a good alternative for free access to good quality scientific information."


Fidel Toldrá
(Instituto de Agroquimica y Tecnologia de Alimentos, Spain)

"Open access journals have become a fundamental tool for students, researchers, patients and the general public. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. The articles are among the best and cover most scientific areas."


M. Bendandi
(University Clinic of Navarre, Spain)

"These journals provide researchers with a platform for rapid, open access scientific communication. The articles are of high quality and broad scope."


Peter Chiba
(University of Vienna, Austria)

"Open access journals are probably one of the most important contributions to promote and diffuse science worldwide."


Jaime Sampaio
(University of Trás-os-Montes e Alto Douro, Portugal)

"Open access journals make up a new and rather revolutionary way to scientific publication. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists."


Eduardo A. Castro
(INIFTA, Argentina)

"Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. The articles published in the open access journals are high quality and cover a wide range of fields."


Kenji Hashimoto
(Chiba University, Japan)

"Open Access journals offer an innovative and efficient way of publication for academics and professionals in a wide range of disciplines. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. I read Open Access journals to keep abreast of the recent development in my field of study."


Daniel Shek
(Chinese University of Hong Kong, Hong Kong)

"It is a modern trend for publishers to establish open access journals. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category."


Jih Ru Hwu
(National Central University, Taiwan)


Browse Contents



Table of Contents


Webmaster Contact: info@benthamopen.net
Copyright © 2020 Bentham Open