Intubation Checklist for COVID-19 Patients: A Practical Tool for Bedside Practitioners

Area of Science:

• Critical Care Medicine
• Infectious Disease Control
• Patient Safety

Background:

• Intensive care unit (ICU) clinical staff face high risks from aerosolizing procedures like endotracheal intubation during the COVID-19 pandemic.
• Existing guidelines for safe endotracheal intubation in COVID-19 patients are limited, necessitating specific protocols.
• An intubation checklist can serve as a safeguard to reduce exposure risk for healthcare workers.

Purpose of the Study:

• To outline the development and refinement of a COVID-19 intubation checklist and operational protocol for ICU staff.
• To provide specific, step-by-step guidance for safe endotracheal intubation in the context of COVID-19.
• To establish a pragmatic bedside tool for clinicians managing high-risk intubations.

Main Methods:

• A standard pre-intubation checklist was adapted and refined through a multidisciplinary, iterative consensus process.
• The refined checklist was distributed to local staff for clinical implementation.
• Mock intubation training sessions and debriefings were conducted to ensure proficiency and identify areas for further refinement.

Main Results:

• The COVID-19 intubation checklist optimized safety during high-risk procedures.
• The checklist minimized aerosolization of secretions.
• It also reduced the number of staff in the room, time spent in the room, and the frequency of personal protective equipment (PPE) use.

Conclusions:

• The developed COVID-19 intubation checklist is a pragmatic bedside tool for clinicians.
• The checklist enhances safety by minimizing exposure risks during endotracheal intubation.
• The checklist development process can serve as a model for other facilities creating pandemic protocols.