How to safely manage COVID-19 respiratory failure patients

The Montgomery County Hospital District EMS shares its specific airway algorithm and a COVID-19 airway management update

EMS and emergency medicine practice has turned 180 degrees in the last few weeks. Now our collective focus is on how to diagnose patients with suspected COVID-19 infections, as well as appropriate testing and disposition to the appropriate facility.

This disease process is a game-changer for EMS in that we now require strict adherence to personal protective equipment guidelines when approaching these patients to mitigate risk to our healthcare professionals.

One of the identified hallmarks of this disease is the concept of “silent hypoxemia,” or simply said – where the numbers look worse than our patient. There is emerging evidence for this phenomenon and our latest podcasts and attached algorithm address what we believe to be the best practice of how to safely manage these respiratory failure patients.

COVID-19 Update

Attacking the COVID-19 Airway

COVID-19 Airway Update

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About the author

The MCHD Paramedic Podcast was launched in early 2018 in an effort to provide easily consumable core-content EMS education and insights from prehospital care thought leaders. The Clinical Services Department of The Montgomery County Hospital District EMS service developed the podcast as a tool to better engage and disseminate continuing education to our MCHD medics as well as first responders and EMS professionals nationwide.

Dr. Casey Patrick is the assistant medical director for Montgomery County Hospital District EMS and is a practicing emergency physician in multiple community emergency departments across Greater Houston. His EMS educational focus is on innovative paramedic teaching via the MCHD Paramedic Podcast. Dr. Patrick’s prehospital clinical research involves the investigation of paramedic use of bolus dose intravenous nitroglycerin for acute pulmonary edema and the implementation of lung protective ventilation strategies for intubated EMS patients. Casey and his wife, Alyssa, work and live in Conroe, Texas, and Spokane, Washington. Together they have five children: Mia, Ainsley, Brock, Dean and Will.

Dr. Dickson graduated with honors from the University of Texas Health Science Center San Antonio in 2001 and completed emergency medicine training at Indiana University in 2004. He serves as the EMS medical director at Montgomery County Hospital District EMS and an assistant professor of emergency medicine at Baylor College of Medicine in Houston, Texas. His academic interests include systems of care in stroke and other time-sensitive emergencies, neurologic emergencies and education. He is board certified in emergency medicine in both the U.S. and Australasia, and has subspecialty board certification in EMS medicine. He has authored multiple professional articles and presented at regional, national and international conferences on emergency medicine and EMS topics.