Guidelines - Anaesthesia 2020, 75, 785–799

Consensus guidelines for managing the airway in patients with COVID-19
Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists

T. M. Cook,1 K. El-Boghdadly,2 B. McGuire,3 A. F. McNarry,4 A. Patel5 and A. Higgs6
1 Professor, Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital NHS Trust, Bath, UK
2 Consultant, Department of Anaesthesia, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
3 Consultant, Department of Anaesthesia, Ninewells Hospital Dundee, UK
4 Consultant, Department of Anaesthesia, NHS Lothian, Edinburgh, UK
5 Consultant, Department of Anaesthesia, Royal National Throat Nose and Ear Hospital and University College London Hospitals NHS Foundation Trust, London, UK
6 Consultant, Department of Anaesthesia and Intensive Care Medicine, Warrington and Halton NHS Foundation Trust, Warrington, UK

Severe acute respiratory syndrome-corona virus-2, which causes coronavirus disease 2019 (COVID-19), is highly contagious. Airway management of patients with COVID-19 is high risk to staff and patients. We aimed to develop principles for airway management of patients with COVID-19 to encourage safe, accurate and swift performance. This consensus statement has been brought together at short notice to advise on airway management for patients with COVID-19, drawing on published literature and immediately available information from clinicians and experts. Recommendations on the prevention of contamination of healthcare workers, the choice of staff involved in airway management, the training required and the selection of equipment are discussed. The fundamental principles of airway management in these settings are described for: emergency tracheal intubation; predicted or unexpected difficult tracheal intubation; cardiac arrest; anaesthetic care; and tracheal extubation. We provide figures to support clinicians in safe airway management of patients with COVID-19. The advice in this document is designed to be adapted in line with local workplace policies.

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