Recommendations for airway management in a suspected or confirmed case with COVID-19. A protocol of the Department of Cardiovascular Anesthesia of the National Institute of Cardiology Ignacio Chávez

Humberto Álvarez-Rosales, Departamento de Anestesiología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Bernardo J. Fernández-Rivera, Departamento de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Raúl Guillén-Rojas, Departamento de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Dania E. Escamilla-Ríos, Servicio de Terapia Intensiva Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Rafael Herrera-Elizalde, Department of Anesthesiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
Esli Telona-Fermán, Departamento de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Carlos Vargas-Trujillo, Departamento de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Pablo Núñez-Trejo, Departamento de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Óscar M. Angulo-Lara, Departamento de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Jesús V. Vela-Roque, Departamento de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
María A. Minakata-Quiroga, Departamento de Anestesia Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Yazmin Guillén-Dolores, Departamento de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México

The new coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), detected in Wuhan, China, causes coronavirus disease 2019 (COVID-19), which was declared pandemic, and has caused more than 19 million confirmed cases and more than 700 thousand deaths worldwide. When our institution was converted to COVID’s hospital since early April 2020, specific care protocols were developed, with the aim of improving the quality of care and safety of patients and the staff involved in their management. Airway management represents one of the highest risks of direct contact infection with aerosol generation (orotracheal intubation, secretion aspiration, extubation, cardiopulmonary resuscitation, high flow oxygen therapy, noninvasive ventilation, and invasive ventilation). We present the current recommendations for airway management as well as a step-by-step airway management protocol to carry out a more secure procedure based on the literature reported so far.

Keywords: Airway management. Rapid sequence intubation. COVID-19.