ABSTRACT
With the first case of COVID-19 confirmed in Canada in early 2020, our country joined in the fight against a novel pathogen in a global pandemic. The stress of uncertainty and practice change was most apparent in the emergency department when it came to managing known or suspected COVID-19 patients requiring airway management. Recognizing the need for a coordinated approach, a province wide rapid response distributed model of continuing professional development for airway management was developed utilizing Airway Leads to help prepare front-line medical personnel providing airway management for these patients. Airway Leads worked with local physicians to deliver consistent, high quality airway education across the province during the initial surge of cases. Education included both in person and virtual sessions along with real time ongoing support through provincial guidelines, videos, and other documents. Physician reported "stress level" pre- and post-Airway Lead support declined from a median score of 9 to 7 (on a 10-point Likert Scale).
RéSUMé: Le premier cas de COVID-19 ayant été confirmé au Canada au début de 2020, notre pays s'est joint à la lutte contre un nouveau pathogène dans une pandémie mondiale. Le stress de l'incertitude et du changement de pratique était plus évident au service d'urgence lorsqu'il s'agissait de gérer les patients connus ou soupçonnés de la COVID-19 qui avaient besoin d'une prise en charge des voies respiratoires. Reconnaissant la nécessité d'une approche coordonnée, un modèle de développement professionnel continu distribué à l'échelle de la province pour la gestion des voies aériennes a été élaboré en utilisant les Airway Leads pour aider à préparer le personnel médical de première ligne qui assure la gestion des voies aériennes de ces patients. Airway Leads a travaillé avec les médecins locaux pour dispenser un enseignement cohérent et de haute qualité sur les voies aériennes dans toute la province lors de l'augmentation initiale du nombre de cas. L'éducation comprenait à la fois des sessions en personne et virtuelles ainsi qu'un soutien continu en temps réel par le biais de directives provinciales, de vidéos et d'autres documents. Le "niveau de stress" déclaré par le médecin avant et après l'intervention de Airway Lead a diminué, passant d'un score médian de 9 à 7 (sur une échelle de Likert de 10 points).
Subject(s)
Airway Management , COVID-19/epidemiology , Clinical Competence , Emergency Medicine/education , Models, Educational , Pandemics , COVID-19/therapy , HumansSubject(s)
Airway Management/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Critical Care/standards , Emergency Medical Services/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Transportation of Patients/standards , Algorithms , Betacoronavirus , COVID-19 , Canada/epidemiology , Humans , Infection Control/standards , Pandemics , Personal Protective Equipment , SARS-CoV-2ABSTRACT
A previously healthy 42-year-old male developed a fever and cough shortly after returning to Canada from overseas. Initially, he had mild upper respiratory tract infection symptoms and a cough. He was aware of the coronavirus disease-2019 (COVID-19) and the advisory to self-isolate and did so; however, he developed increasing respiratory distress over several days and called 911. On arrival at the emergency department (ED), his heart rate was 130 beats/min, respiratory rate 32 per/min, and oxygenation saturation 82% on room air. As per emergency medical services (EMS) protocol, they placed him on nasal prongs under a surgical mask at 5 L/min and his oxygen saturation improved to 86%.