New Tool Tracks Outcomes for Health Care Workers Performing COVID-19 Intubations

A worldwide tracking tool called intubateCOVID will measure exposures and outcomes among health care providers who perform intubations in patients with the novel coronavirus.

A team from the Perelman School of Medicine at the University of Pennsylvania is managing the US component of this global tool, which was created by a team in the United Kingdom, according to a press release. The tracker aims to protect health care providers, including anesthesiologists, nurse anesthetists, and emergency or critical care physicians, and better quantify their risk of acquiring the infection. The team also wants to understand how specific personal protective equipment (PPE) practices or techniques used in intubations may affect health care workers’ risk of infection.

About 1% of patients with coronavirus disease 2019 (COVID-19) require mechanical ventilation to keep their oxygen levels stable. The breathing tube must first be set up by a health care provider.

“Placing a breathing tube in patients with COVID-19 can pose a high risk to health care workers, as it may expose them to aerosols and droplets from a patient’s airways,” Mark Neuman, MD, the Horatio C. Wood Associate professor of anesthesiology at Penn and the national lead for intubateCOVID, said in the statement.

“In order to inform and best protect clinicians performing these procedures, it’s imperative we understand how participating in intubation procedures may be linked to an individual’s risk of developing COVID-19.”

There currently is no large-scale data to quantify if health care workers who perform these intubation procedures are at higher risk for COVID-19, but early data suggests that frontline health care workers have a higher incidence for the virus than the general public.

More than 2000 providers in 500 hospitals around the world, including Europe and Australasia, have so far joined the global registry. More countries are expected to join in the coming days and weeks.

The intubateCOVID tool so far includes data for 1550 intubations, according to the statement. The tool is open to physicians, non-physicians who perform airway management procedures, certified registered nurse anesthetists, and anesthesiologist assistants.

Health care providers using the tool are encouraged to record data from every intubation they perform, regardless of if patients have suspected or confirmed COVID-19 infection. There are data collection fields for details such as the airway technique and the PPE used during the procedure.

Then, after the procedure, health care workers are encouraged to add any new symptoms they experience or if they are diagnosed with COVID-19.

“Our goal is to rapidly capture and analyze large-scale data to identify whether these providers are at an elevated risk and, if so, whether the use of specific techniques or PPE helps to reduce that risk,” Neuman said.

The Foundation for Anesthesia Education and Research, a related organization of the American Society of Anesthesiologists, endorsed intubateCOVID and so did the Society for Airway Management, Anesthesia Patient Safety Foundation, and International Anesthesia Research Society.

The tool to log intubations can be found at intubateCOVID.org and on twitter @intubatecovid.