MIST (Modified Intubating Sequence for Transmissibility) Bundle for Infectious Diseases with Aerosol Hazard

West J Emerg Med. 2020 Aug 17;21(5):1076-1079. doi: 10.5811/westjem.2020.7.47473.

Abstract

The current global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has magnified the risk to healthcare providers when inititiating airway management, and safe tracheal intubation has become of paramount importance. Mitigation of risk to frontline providers requires airway management to be an orchestrated exercise based on training and purposeful simulation. Role allocation and closed-loop communication form the foundation of this exercise. We describe a methodical, 10-step approach from decision-making and meticulous drug and equipment choices to donning of personal protective equipment, and procedural concerns. This bundled approach will help reduce unplanned actions, which in turn may reduce the risk of aerosol transmission during airway management in resource-limited settings.

MeSH terms

  • Aerosols
  • Airway Management / instrumentation
  • Airway Management / methods*
  • Airway Management / standards
  • Betacoronavirus*
  • COVID-19
  • Clinical Decision-Making / methods*
  • Coronavirus Infections / therapy
  • Coronavirus Infections / transmission*
  • Developing Countries
  • Humans
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control*
  • Interprofessional Relations
  • Pandemics
  • Patient Care Bundles / instrumentation
  • Patient Care Bundles / methods*
  • Patient Care Bundles / standards
  • Patient Care Team / organization & administration
  • Personal Protective Equipment
  • Pneumonia, Viral / therapy
  • Pneumonia, Viral / transmission*
  • SARS-CoV-2

Substances

  • Aerosols