Protection of Anesthesia and Perioperative Personnel

Anesthesia Provider Protection: 

For all procedures requiring intubation, the anesthesia provider will wear: 

  • N95 mask or powered air-purifying respirator (PAPR)  
  • One or the other: N95 and PAPR should not be worn at the same time 
  • PAPR should only be used if the N95 does not fit effectively 
  • Face shield (unless using the PAPR, then the face shield is not required) 
  • Gloves 
  • Impervious gown 
  • Staff should not wear an orthopedic hood as it does not have sufficient filtration.   

If the patient is COVID-19 positive or a patient under investigation (PUI), they should be intubated and extubated in a negative pressure room as noted in an earlier Incident Command release titled PPE Protocol for Airway Procedures

The number of staff in the room should be limited to essential personnel only. One scrub person, one circulator, one anesthesia provider, and one first assistant or resident as indicated by the case intensity.  In some instances, additional personnel e.g., perfusionists may be needed but their presence should be limited.   

Other staff in the room should wear N95 masks during the intubation and extubation and, if possible, stand at least six feet away from the head of the bed during those procedures. After extubation, unless the staff is wearing an N95 mask, staff should delay entry into the room until sufficient time has elapsed for enough air changes to remove potentially infectious particles. 

N95 masks should not be stored in brown paper bags for reuse for future days. Masks should be placed in the bin to be decontaminated and reprocessed.    

April 3, 2020