Publications

Significant Need

The novel SARS-CoV2 virus is noted to causes significant viral pneumonia in patients leading to the Acute Respiratory Distress Syndrome (ARDS) and hypoxic respiratory failure. As such, many of these patients will require intubation and mechanical ventilation. Airway management in these patients exposes healthcare workers to very high risk exposures. A modified protocol for airway management is necessary to ensure the procedure can be safely accomplished while utilizing the minimum number of healthcare providers and maximizing their protective equipment.

Solution

The Michigan Medicine Department of Emergency Medicine quickly recognized the need for a rapidly modified airway algorithm that would provide the necessary care to critically ill COVID+ patients while ensuring maximum healthcare worker safety. We reviewed all available best practices from experiences of other health systems around the world that had undergone similar challenges including those in China, South Korea, Hong Kong, Italy and several in the United States. We coalesced these best practices into an airway management protocol that is highly scalable and translatable across healthcare environments and health systems of all different sizes with wide ranges of resources. The protocol has now been widely circulated statewide, nationally and internationally through various mechanisms including the Michigan College of Emergency Physicians, the Michigan Emergency Department Improvement Collaborative the American College of Emergency Physicians, as well as many others. We recently heard it has even been utilized in extreme rural Alaska.

Competitive Advantage

Our algorithm incorporates best practices based on very recent experiences from around the world. It maximizes intubation first pass success while protecting the proceduralist and other healthcare workers. We have paired it with some high yield infographics (thanks Kate Murphy) for rapid dissemination and uptake by practicing clinicians. We have also created a robust in-situ simulation program for our physicians and nurses to practice the procedure, provide immediate feedback and continue to allow us to revise the protocol as we discover better ways to do things. We have trained over a hundred emergency physicians, nurses, respiratory therapists, anesthesiologists, intensivistsand others across our institution in the first week of the rollout so it seems to be a highly effective way to rollout multidisciplinary training.

Commercialization Path

The algorithm does not require or need funding at the current time. It was developed by us to keep both patients and healthcare providers safe while performing aggressive medical care in a time of high risk and high anxiety. It is merely our way of advancing the field of medicine and disseminating valuable knowledge to our colleagues around the world in the battle against COVID-19.