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The International Student Journal of Nurse Anesthesia Volume 19 Issue 2 Summer 2020 The International Student Journal of Nurse Anesthesia TOPICS IN THIS ISSUE COVID-19 Protection during Airway Manipulation COVID-19 Nasotracheal Intubation COVID-19 Cloth Mask Technology COVID-19 N95 Decontamination COVID-19 Artificial Intelligence COVID-19 Hypercoagulability Sniffing Position vs Simple Head Extension Cesarean Section for Non-viable Fetus Bent Central Catheter and Guidewire Tumescent Fluid in Plastic Surgery Trisomy 21 Airway Management Failed Tracheostomy Insertion Hypoglossal Nerve Stimulator Zenker’s Diverticulectomy Autoimmune Encephalitis Dilated Cardiomyopathy Epidermolysis Bullosa Vasoplegic Syndrome Intrathecal Tetracaine Pediatric Craniotomy Adrenal Insufficiency Delayed Emergence Brugada Syndrome Vasculopathy Methadone ROTEM INTERNATIONAL STUDENT JOURNAL OF NURSE ANESTHESIA Vol. 19 No. 2 SUMMER 2020 Editor Associate Editor Vicki C. Coopmans, PhD, CRNA, CHSE Julie A. Pearson, PhD, CRNA Editorial Board Laura Ardizzone, DNP, CRNA, DCC Memorial Sloan Kettering Cancer Center; NY, NY LTC Sarah Bellenger, MSN, CRNA, ANC, USA LifeLinc Anesthesia Dawn Elizabeth Bent, DNP, MSN, CRNA University of Pennsylvania Laura S. Bonanno, PhD, DNP, CRNA Louisiana State University Health Sciences Center CDR Raymond Bonds, DNP, CRNA, CHSE, NC, USN Uniformed Services University Carrie C. Bowman Dalley, PhD, CRNA Georgetown University Greg Bozimowski, DNP, CRNA University of Detroit Mercy Terri M. Cahoon, DNP, CRNA Samford University Marianne S. Cosgrove, PhD, DNAP, CRNA Yale New Haven Hospital School of Nurse Anesthesia LTC Denise Cotton, DNAP, CRNA, ANC, USA Ryder Trauma Center; Miami, FL Janet A. Dewan, PhD, CRNA Northeastern University Marjorie A. Everson, PhD, CRNA Johns Hopkins University Anne Marie Hranchook, DNP, CRNA Oakland University-Beaumont Terri Kane, DNAP, CRNA Texas Wesleyan University Ilene Klassy, MSN, CRNA University of Wisconsin Medical School Brian Koonce, DNAP, CRNA Texas Wesleyan University John Litchfield, PhD, CRNA Georgetown University Connie L. Lorette, PhD, CRNA Northeastern University Dan Lovinaria, DNP, MBA, APRN, CRNA,CHSE, FNAP Hennepin Healthcare Level 1 Trauma Center Ann Miller, DNP, CRNA Florida International University CDR Chad Moore, DNP, CRNA, CHSE, NC, Uniformed Services University Virginia “Chris” Muckler, DNP, CRNA, CHSE-A Duke University Ryan L. Nations, PhD, CRNA Uniformed Services University Johanna Newman, DNAP, CRNA Florida Gulf Coast University Teresa Norris, EdD, CRNA University of Southern California Crystal Odle, DNAP, CRNA Lincoln Memorial University Shannon Pecka, PhD, CRNA Bryan College of Health Sciences Sarah Perez, MS, MSN, CRNA Washington University School of Medicine; St. Louis, J. Dru Riddle, PhD, DNP, CRNA, FAAN Texas Christian University Michael Rieker, DNP, CRNA, FAAN Wake Forest School of Medicine Jackie Rowles, DNP, MBA, CRNA, ANP-BC, FNAP, FAAN The International Federation of Nurse Anesthetists LTC Peter Strube, DNAP, MSNA, MBA, CRNA, APRN, APNP, ARNP, AN, USA University of Wisconsin, Oshkosh Bryan Tune, DNP, CRNA Fresno State University Maria Van Pelt, PhD, CRNA Northeastern University Tina Williams, MSN, CRNA Carl R. Darnall Army Medical Center; Fort Hood, TX Kelly Wiltse Nicely, PhD, CRNA Emory University Lori Ann Winner, MSN, CRNA University of Pennsylvania Stephanie Woodruff, DNP, MSN, CRNA Cedar Crest College Kathleen R. Wren, PhD, CRNA University of Wisconsin, Oshkosh Contributing Editors for this Issue Steven L. Belmont, DNP, CRNA, APRN Fairfield University Leonardo Campero, DNAP, CRNA Keiser University Ramana Duvvuri, MD University of Southern California Sharon Hadenfeldt, PhD, CRNA Bryan College of Health Sciences Lisa Herbinger, DNP, CRNA Samford University Judy Koempel, MSN,CRNA Children’s Hospital Los Angeles Erica McCall, MSN, MPH, CRNA University of Southern California Robert A. Olson, DNAP, CRNA University of Southern California Kate Saftner, MSN, CRNA Wake Forest School of Medicine James Sperle DNP, CRNA University of North Dakota James Stimpson, CRNA, DNP Westminster College Art Shimata, DNAP, CRNA Westminster College LCDR Lauren Suszan, DNP, MSN, CRNA, NC, USN Uniformed Services University Ken Thompson, DNP, CRNA Wake Forest School of Medicine Reviewers for this Issue Jennifer E. Badeaux, DNP, CRNA Louisiana State University; Health Sciences Center Elizabeth Bamgbose, PhD, CRNA University of Southern California Steven L. Belmont, DNP, CRNA, APRN Fairfield University Garry Brydges, PhD, DNP, MBA, CRNA, ACNP-BC, FAAN MD Anderson Cancer Center Ninotchka Brydges, DNP, MBA, APRN, ACNP-BC MD Anderson Cancer Center Daniel Butts, MSN, CRNA Washington University School of Medicine Jose D. Castillo III, PhD, MS, CRNA, APRN Texas Wesleyan University Katie Cole, DNP, CRNA Emory University Molly Condit, DNP, CRNA University of Wisconsin, Oshkosh Jeffrey R. Darna, DNP, CRNA, ACNP-BC University of Southern California Kristen Dooley, DNP , CRNA Tower Health-Reading Hospital Leah Stuart Feyh, DNAP, MSN, CRNA East Carolina University Timothy Gengler, DNAP, CRNA University of Kansas Marco Gidaro, MSN, CRNA Albert Einstein Medical Center; Philadelphia, PA Dana Hein, DNP, CRNA Tower Health-Reading Hospital Bill Johnson, DNAP, CRNA Middle Tennessee School of Anesthesia Angela Jones, DNP, CRNA, NP-C Michigan State University Susan Krawczyk, DNP, CRNA NorthShore University HealthSystem Jill Layman, DNAP, CRNA Missouri State University Michael MacKinnon, DNAP, FNP-C, CRNA National University Linda McDonald, DNAP, CRNA Oakland University-Beaumont Ronald McGuire, MSN, CRNA Winn Army Community Hospital Lindsey Miller, MSN, CRNA Wake Forest School of Medicine David O'Connor, PhD, DNAP, CRNA Memorial Sloan Kettering Joshua Olson, MS, CRNA Henry Ford Health System Stephanie Kelly Parks, DNP, CRNA University of Southern Mississippi Rachel Rachler, CRNA, DNAP, APRN Central Connecticut State University Jennifer Raynor, MSN, CRNA Children’s Hospital of Philadelphia Mike Rybak, MSN, CRNA Washington University School of Medicine Jeanie Skibiski, DNAP, CRNA Missouri State University Matthew Stewart , MS, CRNA NorthCrest Medical Center; Springfield, TN Nathan Stortroen DNP, CRNA Texas Wesleyan University Andrea Teitel, MS, CRNA University of Detroit Mercy Denise H. Tola, DNP, CRNA, CHSE Duke Universiy Jorge Valdes, DNP, CRNA, APRN Barry University Terri S. Williams, CRNA, DNAP, APRN Nurse Anesthesia Program of Hartford 2 Front Cover: This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19). Photo Credit & Content Providers: Alissa Eckert, MSMI, & Dan Higgins, MAMS https://phil.cdc.gov/Details.aspx?pid=23312 The opinions contained in this journal are those of the authors and do not necessarily represent the opinions of the program or the University. Disclaimer for all articles authored by military personnel: The views expressed in this journal are those of the authors and do not necessarily reflect the official policy or position of their respective Military Department, Department of Defense, nor the U.S. Government. The work was prepared as part of the official duties of the military service member. Title 17 U.S.C. 105 provides that ‘Copyright protection under this title is not available for any work of the United States Government’. Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member or employee of the United States Government as part of that person’s official duties. Publication Information: The International Student Journal of Nurse Anesthesia (ISSN 2688-5263) is published three times a year in the spring, summer, and fall. Current and past issues, and the Guide for Authors of this free, open access, electronic journal can be found at: www.aana.com - Member Resources Students International Student Journal https://www.aana.com/studentjournal https://ifna.site/international-publications/international-student-journal-for-nurse-anesthesia/ For additional information, please contact: Vicki Callan Coopmans, PhD, CRNA Webster University Department of Nurse Anesthesia Browning Hall, ISB 107 8274 Big Bend Blvd. St. Louis, MO 63119 314-246-5928; [email protected] 3 Table of Contents COVID-19 Innovation Reports COVID-19: Protecting Anesthesia Practitioners During Airway Manipulation .....................6 Sarah Jean Kopriva, Wake Forest School of Medicine Novel Technique for Nasotracheal Intubation during the COVID-19 Pandemic....................9 Stephen Williams, Wake Forest School of Medicine Artificial Intelligence to Determine Treatment of COVID-19 .................................................13 Katherine R. Bliss, Keiser University COVID-19 Pandemic N95 Decontamination for Reuse ...........................................................15 Rose Marthe Esther Buteau, Keiser University New Cloth Mask Technology during COVID-19 ......................................................................19 Porsha Neal, Keiser University Hypercoagulability in COVID-19 Patients ................................................................................23 James Ciaburri, Yale New
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