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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