The American Society of Anesthesiologists (ASA) held an online town hall on Thursday night to provide answers and updates on practice standards for treating patients with COVID-19.

Among the main topics of interest were the lack of availability of personal protective equipment (PPE), how providers should approach intubating patients suspected of having COVID-19, and whether elective surgeries should be canceled amid the pandemic.

Mary Dale Peterson, MD, the ASA president, gave opening remarks to highlight the urgency and gravity of the present situation.

“Our nation is in the middle of a historic public health crisis,” Dr. Peterson said, “and we are on the front lines.”

Dr. Peterson was joined by a panel of experts from the Anesthesia Patient Safety Foundation (APSF) and several ASA committee members to answer questions from over 6,000 participants.

One of the main concerns from members was how elective surgeries should be managed during the pandemic. The ASA and the panelists recommended that nonessential surgeries be postponed so resources, such as PPE and hospital staff, can be conserved for urgent cases, and that telemedicine should be practiced whenever possible.

The dwindling supply of PPE was also chief among members’ concerns and the recommendation was to conserve those resources for high-risk cases. The panelists suggested using N95 masks only with patients who are suspected of having COVID-19 and to use additional protective equipment, such as eye shields and surgical masks, to protect the providers and the N95 masks.

In addition, they suggested following CDC guidelines for reusing N95 masks to conserve the supply by adopting proper sanitizing and storing practices.

Another key point was the potential for adapting anesthesia machines for use as ventilators in the ICU. Several panelists stressed the need to make key alterations and to properly filter the machines, as it is possible to contaminate them when they are used in cases involving patients with COVID-19. After the case, they suggest cleaning and disinfecting high-touch surfaces on the machines with a hospital disinfectant approved by the Environmental Protection Agency.

The ASA does not recommend adapting these machines immediately, but it is considered an option of last resort for overwhelmed health care facilities. The ASA website provides further details on accomplishing optimal alterations and filtration for anesthesia machines.

The possibility of implementing dedicated intubation teams to focus exclusively on intubating patients also was discussed as a way to protect all hospital staff from repeated high-exposure procedures. Several panelists noted that it was a successful method used in China at the height of the crisis there. They also said this practice would be ideal for protecting any high-risk providers from those higher exposure procedures.

Dr. Peterson gave an update on how the ASA is working with the federal government to help prepare for the coming weeks. She said she presented growing concerns over the lack of availability of PPE during a teleconference with the White House coronavirus task force this week. She also said she promoted the potential for anesthesiologists to provide support by reconfiguring existing anesthesia machines into ventilators to aid treatment of patients with COVID-19.

For up-to-date information about treating patients with COVID-19. go to asahq.org/covid19info.

—Michael DePeau-Wilson