Monitored Anesthesia Care in Adults
Understanding of coronavirus disease 2019 (COVID-19) is evolving. UpToDate has added information on many aspects of COVID-19, including infection control, airway and other aspects of anesthetic management, and intensive care, in topic reviews linked at the end of this section. Important issues related to monitored anesthesia care (MAC) include the following:
● Patients requiring urgent procedures under MAC may not have been tested for COVID-19; their COVID-19 status can be considered either unknown or suspected.
● MAC should be performed by experienced anesthesiologists and in procedures with a low rate of conversion from MAC to general anesthesia. Conversion to general anesthesia increases the risk of transmission of the virus to health care providers as bag-mask ventilation, intubation, extubation, and airway suctioning may result in aerosolization of respiratory secretions.
● When patients are receiving supplemental oxygen (O2) during MAC, a surgical mask should be placed over the O2 facemask or nasal cannula . If available, O2 masks with expiratory viral filters may be used.
●O2 flow through nasal cannula should be minimized according to clinical need. Aerosolization may occur with O2 flow rates >5 L/minute.
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