Comparative performance of two protective barriers during tracheal intubation of COVID-19 patients: A simulation cross-over study

Abdullah B Abolkheir, Ahmed El-Kabbani, Abdullah Al Raffa, Areej AlFattani, Andrew NorrisSaudi Journal of Anaesthesia 2021 15(4):396-402 COVID-19 was declared a pandemic by the WHO in 2020. In light of the global shortage of PPE and concerns regarding the safety of healthcare providers, clinicians have resorted to the use of novel protective barriers, such as aerosol boxes and plastic sheets, during aerosol generating procedures, especially tracheal intubation. We compared the effect of these barriers on the tracheal intubation of simulated patients with severe COVID-19 in a crossover study. The study was approved by the Ethics Committee of King Faisal Specialist Hospital, and the procedures were compliant with the COVID-19 airway management guidelines of the Saudi Anesthesia Society. The time to intubation was our primary outcome. Secondary outcomes included number of optimization maneuvers, number of intubation attempts, time to glottic view and ventilation of the lungs, and damage to PPE. Thirteen consultant anesthetists performed 39 tracheal intubations on a manikin using each of three approaches (aerosol box, plastic sheet, and no-barrier). Data were collected via direct and video observation. The plastic sheet approach demonstrated the highest time to intubation (mean ± StE [95% CI]: 33.3s ± 3.5 [25.8– 40.9]) compared to the aerosol box (22.0s ± 2.5 [16.5 – 27.5], P < 0.01) and no-barri...
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research