Aerosol box for intubation of patients with suspected COVID-19: simulation study

  • Saúl Álvarez Robles School of Health, Universidad Industrial de Santander. Bucaramanga. Colombia.
  • Claudia Consuelo Torres Contreras School of Nursing, Universidad de Santander. Bucaramanga. Colombia. https://orcid.org/0000-0001-7064-9380
  • Raquel Rivera Carvajal School of Nursing, Universidad de Santander. Bucaramanga. Colombia. https://orcid.org/0000-0003-0666-9285
  • Víctor Manuel Lucigniani Ariza School of Health, Universidad Industrial de Santander. Bucaramanga. Colombia.
  • Sonia Margarita Vivas García Anesthesiology and Resuscitation Graduate Program, School of Health, Universidad Industrial de Santander. Bucaramanga. Colombia.
Keywords: Intra-tracheal intubation, Respiratory protection devices, SARS virus, Anesthesiology

Abstract

Introduction. Endotracheal intubation is a procedure associated with a high level of exposure to the COVID-19 virus. This has led to the search of alternatives to reduce the risk of contamination, including the so-called aerosol box.

Objective: To compare time and difficulty of orotracheal intubation when using the aerosol box in a simulated setting.

Methodology: Observational study conducted with the participation of 33 anesthetist physicians and anesthesia residents; groups were compared in terms of time and intubation difficulty using a conventional Macintosh laryngoscope and the McGRATH™ MAC (Medtronic) videolaryngoscope with or without aerosol box. In order to determine performance with the intubation maneuver, crude hazard ratios were estimated, and a Cox multivariate regression model was built, adjusted by anesthetist years of experience and difficulties during the procedure.

Results: On average, the aerosol box increased intubation time by 7.57 seconds (SD 8.33) when the videolaryngoscope was used, and by 6.62 (SD 5.74) with the Macintosh. Overall, 132 intubations were performed, with 121 successful and 6 failed first-time attempts (4 with the use of the aerosol box); 16 participants (48.48%) reported difficulty handling the box. With the use of the Macintosh, intubation was found to be faster than with the videolaryngoscope (cHR: 1.36 [95% CI 0.64-2.88]; adjusted HR: 2.20 [95% CI 0.73-6.62]).

Conclusions: The use of the aerosol box and personal protective equipment in a simulation setting hinders the intubation maneuver and may result in protracted execution time.

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How to Cite
1.
Álvarez Robles S, Torres Contreras CC, Rivera Carvajal R, Lucigniani Ariza VM, Vivas García SM. Aerosol box for intubation of patients with suspected COVID-19: simulation study. Colomb. J. Anesthesiol. [Internet]. 2021Oct.4 [cited 2021Dec.5];49. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1006

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Published
2021-10-04
How to Cite
1.
Álvarez Robles S, Torres Contreras CC, Rivera Carvajal R, Lucigniani Ariza VM, Vivas García SM. Aerosol box for intubation of patients with suspected COVID-19: simulation study. Colomb. J. Anesthesiol. [Internet]. 2021Oct.4 [cited 2021Dec.5];49. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1006
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