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


© 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 [1]. 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 [2]. Intubation is one of the highest risk moment for COVID-19 spread to HCWs and other patients [3, 4]. 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 [5]. 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 [6, 7].

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

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