Anaesthetists take the lead on high-risk procedures

An intubation team preparing for COVID-19 process

With the experience of overseas medical professionals working with coronavirus patients and their knowledge of high-risk aerosol-generating procedures, our anaesthetists have put in place strong measures to reduce the risk of COVID-19 transmission.

Across Monash Health, just over 200 anaesthetists, consultants and registrars have already been trained in the latest use of Personal Protective Equipment (PPE) and modified ways to approach a patient who has a known or likely infection.

Acting Service Director of Anaesthetics for Monash Health, Mark Adams, and his colleagues across the health service have swung into action and put in place the appropriate structures and training to reduce the risk of COVID-19 transmission and to provide round-the-clock advice to medical teams.

“We are as close to 100 per cent as we can get, with just over 200 anaesthetists, consultants and registrars already trained,” Mark said.

The first step was reducing elective surgery so that employees working in high-risk roles such as anaesthetists, nursing employees, ENT surgeons, maxillofacial surgeons and others could receive extra training in PPE and the different layers needed in different situations.

Under the guidance of eight anaesthetists, the PPE protocols have been developed, and a process and structure put in place so that each of the key areas has contacts and Super Users who are available 24-hours a day to address issues and concerns.

This includes theatre as well as obstetrics, radiology, paediatrics, mental health and more.

Personal Protective Equipment

Mark explained that teams have been working on the ‘donning’ (application) and ‘doffing’ (removal) of PPE, with a ‘spotter’ who watches to make sure it is done properly.

“If I put my hand on my gown, which is contaminated, I can infect myself and potentially others. If I don’t dispose of the gown in the appropriate way, I can spread the contamination around the room. Taking off PPE in the correct way and using appropriate hand hygiene is the most important part of the process to protect ourselves and others.”

Intubation of COVID-19 patients

“Intubating a patient with known or likely infection with COVID-19 may be required for the critically ill, and is a high-risk procedure for those close to that patient’s airway, such as the anaesthetic team. We have developed additional techniques to safely perform this life-saving procedure, protecting employees and the patient.”

We not only have the Super Users, but we are now in the simulation phase across Clayton, Dandenong and Casey. “In theatre, ED and ICU, we have been running through common scenarios, with multidisciplinary teams, and identifying issues and solutions.”

If you haven’t been trained in PPE and need to be, please take complete your online training on Latte and attend a face-to-face PPE training session details for appropriate actions are here.

Pictured: an intubation team at Monash Medical Centre Clayton, going through their checklist before intubating a patient last Sunday. You can see the ‘spotters’ in yellow and the intubation team in blue.

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