COVID-19 respiratory support in the emergency department setting.
COVID-19
/ complications
Emergency Service, Hospital
/ organization & administration
Humans
Infection Control
/ instrumentation
Intubation, Intratracheal
/ adverse effects
Pandemics
Personal Protective Equipment
Respiration, Artificial
/ adverse effects
Respiratory Insufficiency
/ etiology
SARS-CoV-2
Airway
COVID-19
Coronavirus
Emergency medicine
Intensive care
Intubation
SARS-CoV-2
Journal
The American journal of emergency medicine
ISSN: 1532-8171
Titre abrégé: Am J Emerg Med
Pays: United States
ID NLM: 8309942
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
22
04
2020
revised:
26
07
2020
accepted:
01
08
2020
pubmed:
14
10
2020
medline:
2
1
2021
entrez:
13
10
2020
Statut:
ppublish
Résumé
Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease 2019 (COVID-19), may result in severe complications, multiorgan dysfunction, acute respiratory failure, and death. SARS-CoV-2 is highly contagious and places healthcare workers at significant risk, especially during aerosol-generating procedures, including airway management. This narrative review outlines the underlying respiratory pathophysiology of patients with COVID-19 and discusses approaches to airway management in the emergency department (ED) based on current literature. Patients presenting with SARS-CoV-2 infection are at high risk for acute respiratory failure requiring airway management. Among hospitalized patients, 10-20% require intensive care unit admission, and 3-10% require intubation and mechanical ventilation. While providing respiratory support for these patients, proper infection control measures, including adherence to personal protective equipment policies, are necessary to prevent nosocomial transmission to healthcare workers. A structured approach to respiratory failure in these patients includes the use of exogenous oxygen via nasal cannula or non-rebreather, as well as titrated high-flow nasal cannula and non-invasive ventilation. This review offers several guiding principles and resources designed to be adapted in conjunction with local workplace policies for patients requiring respiratory support. While the fundamental principles of acute respiratory failure management are similar between COVID-19 and non-COVID-19 patients, there are some notable differences, including a focus on provider safety. This review provides an approach to airway management and respiratory support in the patient with COVID-19.
Identifiants
pubmed: 33046288
pii: S0735-6757(20)30682-3
doi: 10.1016/j.ajem.2020.08.001
pmc: PMC7413866
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2160-2168Informations de copyright
Published by Elsevier Inc.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.
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