Guidance for Healthcare Professionals Working with Known or Suspected COVID-19 Patients

URL: https://www.asahq.org/about-asa/governance-and-committees/asa-committees/committee-on-occupational-health/coronavirus

The following is a summary of the guidance put forth by the American Society of Anesthesiologists when caring for a patient with known or suspected COVID-19.

There are 4 main scenarios we must discuss when working with any patients with known or suspected COVID-19. These scenarios are as follows:

1. Caring for a patient

2. Considering a procedure for a patient

3. Performing a procedure on a patient

4. Transporting a patient

Let’s dive into the specifics of each of these scenarios and how you can keep everyone safe.

Caring for a Patient

Possible or definitive COVID-19 patients must be placed in an airborne infection isolation room, which is a negative pressure room that prevents contaminated air from recirculating. If this type of room isn’t available, transfer this patient as soon as possible to a location that does have this type of room.

Healthcare workers must wear PPE, including:

1. Fitted N95 mask or a powered air-purifying respirator

2. Face shield or goggles

3. Gown

4. Gloves

5. Eye protection

Make sure you are properly putting on and removing PPE in the correct order. For more information on this, check out this CDC resource.

Considering a Procedure for a Patient

It is essential to postpone any non-urgent surgical procedures until your patients is determined to be non-infectious. If the procedure it urgent, it is recommended to perform procedures in an airborne infection isolation room. If the procedure can’t be postponed, be sure to schedule that procedure when there is a minimum number of healthcare workers and patients present. Be prepared as possible, so another important step is to reach out to your local infection control expert.

Performing a Procedure for a Patient

If you are not using general anesthesia, the patient should continue to wear the surgical mask. If they are getting general anesthesia, or undergoing laryngoscopy or intubation, follow the steps as outlined by the American Society of Anesthesiologists. Other general recommendations include using disposable covers for surfaces or long ultrasound probes, avoid placing patients in the post anesthesia care unit, and letting them recover in the operating room or in an airborne infection isolation room. After the procedure is over, clean and disinfect high-touch surfaces with an EPA-approved disinfectant.

Transporting a Patient

The first thing you should do before transporting a patient is to reach out to a local infection control expert. You only want to transport patients for procedures or studies that are essential for their care. Any patients who are not currently ventilated should wear a surgical mask. Any intubated patients should have a HEPA (high efficiency particulate air) filter inserted between the bag-valve-mask breathing device and the patient. When transporting the patient, one person should be wearing the appropriate PPE per the CDC , and someone else who isn’t coming into contact with the patient shouldn’t wear PPE so they can interact more with the environment and avoid contamination.