Trial reportEmergency medicine journal : EMJ2021
COVID-19 aerosol box as protection from droplet and aerosol contaminations in healthcare workers performing airway intubation: a randomised cross-over simulation study.
Trial report in Emergency medicine journal : EMJ, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interleukin-6 blocking agents for treating COVID-19: a living systematic review.The Cochrane database of systematic reviews · 2021Pooled it
- Aerosol Box Use in Reducing Health Care Worker Contamination During Airway Procedures (AIRWAY Study): A Simulation-Based Randomized Clinical Trial.JAMA network open · 2023Trial
- Comparison of the Efficiency and Usability of Aerosol Box and Intubation Tent on Intubation of a Manikin Using Personal Protective Equipment: A Randomized Crossover Study.The Journal of emergency medicine · 2021Trial
- Article
- Airway Management of Critically Ill Pediatric Patients with Suspected or Proven Coronavirus Disease 2019 Infection: An Intensivist Point of View.Journal of pediatric intensive care · 2024Review
- Does the aerosol box accommodate the double-lumen tube intubation?SAGE open medical case reports · 2024Article
- Introduction of Infection Prevention Tracheal Intubation Protocol during the COVID-19 Pandemic Is Not Associated with First-Pass Success Rates of Endotracheal Intubation in the Emergency Department: A Before-and-After Comparative Study.Journal of personalized medicine · 2023Article
- Efficiency, limitations, and familiarization of a novel negative pressure aerosol box for intubation: a simulation-based randomized crossover study.Clinical and experimental emergency medicine · 2023Article
- Practices During Intubation in COVID-19 Intensive Care Units in India: A Cross-Sectional Questionnaire-Based Survey.Cureus · 2023Article
- A full-face mask for protection against respiratory infections.Biomedical engineering online · 2022Article
- A cross-sectional study of assessing knowledge, attitude, and practice of COVID-19 resuscitation among health care workers in a hybrid hospital for COVID-19 in Malaysia.International emergency nursing · 2022Article
- Airway Management of Patients with Suspected or Confirmed COVID-19: Survey Results from Physicians from 19 Countries in Latin America.Journal of clinical medicine · 2022Article
- Video-Assisted Stylet Intubation with a Plastic Sheet Barrier, a Safe and Simple Technique for Tracheal Intubation of COVID-19 Patients.Healthcare (Basel, Switzerland) · 2022Article
- Aerosol generation during general anesthesia is comparable to coughing: An observational clinical study.Acta anaesthesiologica Scandinavica · 2022Observational
- Updated AHA Basic and Advanced Cardiac Life Support guidance with COVID-19 considerations.Nursing · 2022Article
- Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method.The Lancet. Infectious diseases · 2022Review
- Article
- Simulation and evaluation of the protective barrier enclosure for cardiopulmonary resuscitation.Resuscitation plus · 2021Article
- ORi™: a new indicator of oxygenation.Journal of anesthesia · 2021Review
- Comparison of aerosol box intubation with styletted endotracheal tube and intubation over bougie: A randomized controlled trial.Journal of anaesthesiology, clinical pharmacologyArticle
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConcerns over high transmission risk of SARS-CoV-2 have led to innovation and usage of an aerosol box to protect healthcare workers during airway intubation in patients with COVID-19. Its efficacy as a barrier protection in addition to the use of a standard personal protective equipment (PPE) is not fully known. We performed a simulated study to investigate the relationship between aerosol box usage during intubation and contaminations on healthcare workers pre-doffing and post-doffing of PPE.
methodsThis was a randomised cross-over study conducted between 9 April to 5 May 2020 in the ED of University Malaya Medical Centre. Postgraduate Emergency Medicine trainees performed video laryngoscope-assisted intubation on an airway manikin with and without an aerosol box in a random order. Contamination was simulated by nebulised Glo Germ. Primary outcome was number of contaminated front and back body regions pre-doffing and post-doffing of PPE of the intubator and assistant. Secondary outcomes were intubation time, Cormack-Lehane score, number of intubation attempts and participants' feedback.
resultsThirty-six trainees completed the study interventions. The number of contaminated front and back body regions pre-doffing of PPE was significantly higher without the aerosol box (all p values<0.001). However, there was no significant difference in the number of contaminations post-doffing of PPE between using and not using the aerosol box, with a median contamination of zero. Intubation time was longer with the aerosol box (42.5 s vs 35.5 s, p<0.001). Cormack-Lehane scores were similar with and without the aerosol box. First-pass intubation success rate was 94.4% and 100% with and without the aerosol box, respectively. More participants reported reduced mobility and visibility when intubating with the aerosol box.
conclusionsAn aerosol box may significantly reduce exposure to contaminations but with increased intubation time and reduced operator's mobility and visibility. Furthermore, the difference in degree of contamination between using and not using an aerosol box could be offset by proper doffing of PPE.
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