Eighteen anesthesiologists from five hospitals in the coronavirus-hit city of Wuhan recently formed a team to undertake the task of emergency endotracheal intubation for severely ill patients with the novel coronavirus disease (COVID-19) in Tongji Hospital affiliated to Huazhong University of Science and Technology.

Severely ill patients confirmed to have the disease may develop respiratory failure, making the treatment more difficult. Therefore, endotracheal intubation becomes vital to bring back more lives. As a result, the team was formed to treat sick individuals of 16 inpatient areas as well as one ICU at a hospital.

Gao Feng, director of the Department of Anesthesiology in Tongji Hospital, said that procedures involving emergency endotracheal intubation can be extremely risky, especially for severe cases, due to patients’ poor physical condition, inability to tolerate prolonged hypoxia, and severe fluctuations in blood pressure and heart rate. “Therefore, it must be conducted by extremely experienced anesthesiologists.”

To successfully complete the task, the team set up a unified standard, including personal protection, preparation of articles and intubation procedures, and adhering to a “zero error” principle.

Although endotracheal intubation may seem like a routine medical procedure, each doctor has his own habits and techniques. In order to meet the diversified needs of all anesthesiologists, the Department of Anesthesiology has prepared a “multifunctional toolbox”, which meets the diversified needs of each and every doctor. All necessary items are placed inside for intubation, such as narcotic drugs, vasoactive drugs, disposable intubation appliances and intubation supplies.

“Normally, it takes 15 to 20 minutes to complete an intubation, but with protective suits and three layers of gloves, the field of vision of doctors is severly impaired and movement would all be affected, said Gao. For example, on February 16, two team members on duty were only ale to complete endotracheal intubations for six severely ill patients over a six hour period.

In fact, endotracheal intubation is high-risk, because when anesthesiologists operate in close proximity to an infected person, virus-laden aerosol droplets from the patient may cause person-to-person transmission. “But if we don’t do it, who will?” team members said.

For the past eight days, the team has successfully completed nearly 50 endotracheal intubations, with a 100 percent success rate. The oldest patient was 85 years old.

When an anesthesiologist rushes up, it means the patient is in critical condition. As the extremities surrounding the procedure clarify explained above, the endotracheal intubation team is always in decisive battles against death, said Gao.