A clinical report has highlighted the risks and challenges associated with tracheal extubation during the COVID-19 pandemic. The important and interesting report was authored by Dr. Olu Bamgbade of the Salem Pain Clinic in Surrey, British Columbia, Canada.
Dr. Olu Bamgbade is an anesthesiologist, assistant professor and specialist pain physician who trained in Nigeria, Britain, USA, France and South Korea (https://www.linkedin.com/in/olu-bamgbade-frcpc-md-pain-med-diploma-msc-baa79b18b/). Dr. Olu Bamgbade is the director of the Salem Pain Clinic, a specialist pain clinic and research center (https://salempainclinic.net/). The scientific report was published in the Journal of Taibah University Medical Sciences: https://doi.org/10.1016/j.jtumed.2021.05.002.
Tracheal intubation and extubation are aerosol-generating medical procedures (AGMP), and have become of greater concern during the COVID-19 pandemic. Tracheal extubation generates detectable aerosol at 15-fold greater spread than intubation, especially during coughs. The management of AGMP is more challenging and delicate during a respiratory pandemic because of the increased risk of infection transmission to medical staff, patients and the clinical environment. Despite the high air exchange rates in medical units, tracheal extubation may potentially spread COVID-19 or other respiratory viruses into the clinical environment.
"The risk of AGMP-related viral dissemination must be mitigated, especially during tracheal extubation. Medical staff must utilize personal protective equipment, including face-shields. During tracheal intubation of COVID-19 patients, videolaryngoscopy must be employed instead of direct laryngoscopy to reduce proximity to the patient's airway and aerosol source," said Dr. Bamgbade. "Coughing or other complications of airway management should be minimized by timely efficient airway suctioning, good sedation maintenance/emergence techniques, intravenous lidocaine and intravenous magnesium. Tracheal extubation during simultaneous continuous endotracheal suctioning may significantly minimize airway secretions, coughing, aerosol generation and viral dissemination," explained Dr. Bamgbade. "The COVID-19 respiratory pandemic is a major medical concern; and concerted multidisciplinary team efforts must continue towards reducing the risk of viral spread during airway management. This is essential to minimize AGMP-related viral spread, and to protect clinical staff and patients," advised Dr. Bamgbade.
Based in Surrey, British Columbia, Canada, Salem Pain Clinic is a specialist pain clinic and research center that provides multimodal pain management, interventional pain treatment, substance misuse therapy, insomnia treatment and preoperative optimization therapy. Dr. Olu Bamgbade is an anesthesiologist, a specialist pain physician and the director of the Salem Pain Clinic. Visit https://salempainclinic.net/. For further information: [email protected].
Olu Bamgbade Publications. Google Scholar Oct2022.pdf
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Original Source: Clinical Report by Salem Pain Clinic, Surrey, Canada, Highlights the Challenges and Risks of Endotracheal Airway Care During the COVID-19 Respiratory Pandemic