COVID-19 IES UPDATES | Page 7

Management

Provider Health

Provider Health

PPE: Mask for Patient, Mask for Healthcare Workers, Eye Protection, Gloves, Gown add N95 for Aerosolizing Procedures.

Supportive Care: Oxygen, Cautious IV Fluid Administration

Albuterol:

Avoid nebulizers as these are aerosolizing

Albuterol MDI Inhaler: with spacer, 2 puff q 20 min until relief, then q

4-6 hours, Onset 5-10 min

Albuterol PO: 4 mg TID-QID , Onset 30 min

Terbutaline SC: 0.25 mg q 20 min x 3 (max 0.75 mg/hr), Onset 6-15 min

Terbutaline PO: 5 mg TID, Onset 30-45 min

Epinephrine: 0.1 to 0.3 mg subcutaneous injection, q 20-30 min for total

1 mg, Onset

Click Here for Alternatives to Albuterol.

Oxygen: Nasal Cannula (NC), place surgical mask over nasal prongs

High Flow Nasal Cannula: NC providing more than 6L/min, this with a mask over it, is preferred over CPAP/BIPAP

BiPAP: Consider avoiding as it is aerosolizing, unless appropriate PPE in place

Intubation: If respiratory status deteriorating, early intubation should be considered, have a back up plan.

• PPE: Don PAPR or N95 Mask, Gown, Gloves, Hair Cover

• Most Skilled Person for Intubation

• Pre-Oxygenate: NC with mask covering patient , NC with NRB, jaw lift

thrust, HOB elevated, airway adjuncts, HEPA viral filter over mask

• Suction: closed suction system

• Rapid Sequence Intubation to avoid BVM

- Rocuronium 1.5 – 2 mg/kg IV, longer half life to succinylcholine

• Video Laryngoscopy: avoids face close to patient’s mouth

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Resources, Questions or Concerns Related to COVID-19? Contact the IES COVID Helpdesk

[email protected] | 469.420.5590 | Click Here for Resources