Apnoeic CPAP for oxygenation of COVID-19 patients prior to intubation
Inability to adequately pre-oxygenate critically ill patients, and to maintain oxygenation during induction and laryngoscopy, risks life-threatening hypoxaemia. Intubation of COVID-19 patients is made considerably more complex due to the risk of viral transmission associated with different pre-oxygenation and apnoeic oxygenation strategies.
In this excellent 10 minute video from Adult Retrieval Victoria, Dr Stacy Turner (@StacyTurner99) demonstrates the pros and cons of different approaches for “apnoeic CPAP” to achieve adequate oxygenation of critically ill COVID-19 patients. The current Safe Airway Society COVID-19 Consensus Statement – Airway Management and Tracheal Intubation. are referred to in the video.
Techniques demonstrated include:
- Bag-valve-mask (BVM) with PEEP valve
- Bag-valve-mask (BVM) with PEEP valve and nasal cannula
- Bag-valve-mask (BVM) with PEEP valve and addition oxygen flow distal to the viral filter
- CPAP using the Hamilton C1 ventilator
novel coronavirus of COVID-19