Recommendations for anesthesia in patients suspected of COVID-19 Coronavirus infection

Kim, Hyun Joo; Ko, Justin Sangwook; Kim, Tae-Yop

• Do not allow patients to stay in the holding area. Treatment should be carried out in a pre-allocated negative pressure operating room. Warning signs for COVID-19 infection should be posted in front of the operating room to minimize staff exposure. • Patients should not stay in the recovery room or postoperative care unit. After complete recovery in the operating room, the patient should be transferred into a negative pressure room in a ward or intensive care unit (ICU). • Endotracheal intubation, tube exchange, and extubation are high-risk procedures that can expose healthcare workers to respiratory droplets of the virus. These procedures must be carried out in a location where negative pressure is applied such as negative pressure room, and special care should be taken. • Depending on the clinical situation, performing an endotracheal intubation early in a negative pressure room in a ward or ICU, rather than in an operating room, should be considered. • If it is determined that the degree of negative pressure in the environment is not sufficient, the additional application of a portable high-efficiency particulate air filter should be considered. • A highly efficient hydrophobic filter should be placed between the endotracheal tube and the reservoir bag, to prevent atmospheric contamination by respiratory droplets during patient transfers.