Article Text

Download PDFPDF
Prioritising intubator safety in a pandemic: the details matter
  1. Ryan Barnicle1,
  2. Alexander Bracey2,
  3. Bassam Zahid1,
  4. Alexandra Davic1,
  5. Scott Weingart1
  1. 1 Emergency Medicine, Stony Brook University Hospital, Stony Brook, New York, USA
  2. 2 Emergency Medicine, Albany Medical Center, Albany, New York, USA
  1. Correspondence to Dr Ryan Barnicle, Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY 11794, USA; ryanbarniclemd{at}


Our ED-intensive care unit has instituted a new protocol meant to maximise the safety of physicians, nurses and respiratory therapists involved with endotracheal intubation of patients known or suspected of being infected with the novel SARS-CoV-2. The level of detail involved with this checklist is a deviation from standard intubation practices and is likely unfamiliar to most emergency physicians. However, the two-person system used in our department removes the cognitive burden such complexity would otherwise demand and minimises the number of participants that would typically be exposed during endotracheal intubation. We share this checklist to demonstrate to other departments how adopting international airway guidelines to a specific institution can be achieved in order to promote healthcare worker safety.

  • respiratory
  • airway
  • emergency department
  • safety
  • infectious diseases
  • viral

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Handling editor David Metcalfe

  • Twitter @BraceyA

  • Contributors Outlining, manuscript composition and revisions were provided by RNNB. AB, AD and SW provided significant manuscript editing. SW developed initial protocol for protected intubations to be used in our ED and oversaw manuscript development. BZ and SW created videos and images.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.