MIST (Modified Intubating Sequence for Transmissibility) Bundle for Infectious Diseases with Aerosol Hazard

Abstract

The current global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has magnified the risk to healthcare providers when inititiating airway management, and safe tracheal intubation has become of paramount importance. Mitigation of risk to frontline providers requires airway management to be an orchestrated exercise based on training and purposeful simulation. Role allocation and closed-loop communication form the foundation of this exercise. We describe a methodical, 10-step approach from decision-making and meticulous drug and equipment choices to donning of personal protective equipment, and procedural concerns. This bundled approach will help reduce unplanned actions, which in turn may reduce the risk of aerosol transmission during airway management in resource-limited settings.

Assessment of the Preparedness and Planning of Academic Emergency Departments in India During the COVID-19 Pandemic: A Multicentric Survey

“…(28) Airway management in COVID-19 patients was identified as a challenging issue in the majority of centres, and we observed that 82% of Emergency Medicine consultants underwent separate airway training exercises during the COVID-19 pandemic. (29) This highlights the importance of simulation exercises and targeted training for the current pandemic.…”