|
Membership Forum : COVID-19 Discussion |
|
|
|
| |
|
|
Subject : Staff waiting to enter room..
04/20/2020 06:45:41 PM
|
|
|
| Dr. Aly Branstiter |
|
Posts: 4
Location: |
|
|
|
|
|
Are other centers limiting personnel in the room on intubation/ extubation? How long are you waiting before others enter the room? Does the anesthesiologist wait in the room for X Minutes before leaving after extubation as well?
Just wondering what other anesthesiologist's and center's practices are at this point?
Thanks! |
|
|
|
|
|
|
Subject : Re:Staff waiting to enter room..
04/20/2020 07:00:10 PM
|
|
|
| Leslie Shrem M.D. |
|
Posts: 9
Location: |
|
|
|
|
|
|
|
|
|
Subject : Re:Staff waiting to enter room..
04/20/2020 07:42:50 PM
|
|
|
| Sakura Kinjo |
|
Posts: 1
Location: |
|
|
|
|
|
We do semi-urgent cases in our ambulatory ortho surgery center. Per our protocol, most of our patients are in the "asymptomatic patient for low risk surgery involving GA" category.
We mostly do LMAs. Non-anesthesia providers leave room for intubation and extubation 15 min following. we have all wondered what, if any, aerosol would be created after a smooth, well-seated LMA placement and removal without coughing. We just do not know. To be extra-cautious, we treat LMAs like ETTs. |
|
|
|
|
|
|
Subject : Re:Staff waiting to enter room..
04/20/2020 08:41:48 PM
|
|
|
| Dr. Shaina Drummond |
|
Posts: 2
Location: |
|
|
|
|
|
|
We are waiting 20 minutes after intubation and extubation before staff enter the room based on our OR air clearance cycles per hour (there is a table from the CDC). We are intubating everyone and not using LMAs at this point. My concern with LMAs is that when positive pressure is applied, you could be aersolizing the OR since you don't have a truly secured airway. I honestly wish someone would do a simulation of aersolization with dye and an LMA in place the way they have done with intubation. It's a hard call because there is less coughing most of the time. |
|
|
|
|
|
|
Subject : Re:Staff waiting to enter room..
04/20/2020 08:55:32 PM
|
|
|
| Dr. Janette Covington |
|
Posts: 14
Location: |
|
|
|
|
|
|
I think, however, if it is possible to insert the LMA with spontaneous ventilation and let that continue after insertion, there is very little risk of increased aerosolization compared to using no airway at all - maybe even less since it is contained in the circuit. Certainly I would avoid PPV if at all possible, which should be reasonable to do in the elective setting with LMA. |
|
|
|
|
|
|
Subject : Re:Staff waiting to enter room..
04/21/2020 05:19:46 AM
|
|
|
| Leopoldo Rodriguez, MD, MBA, FAAAP, FASA, SAMBA-F |
|
Posts: 53
Location: |
|
|
|
|
|
|
Yes, we are waiting 10 minutes, following droplet precautions. We do it for GI procedures as well. Before leaving the room, we place a facemask on the patient (level 3) and an oxygen mask on top of it to protect the PACU staff from cough. |
|
|
|
|
| |
