Evidence map›Paper›PMID 33280199›Full record

ArticlePaediatric anaesthesia2021

A comparison of anesthetic protective barriers for the management of COVID-19 pediatric patients.

Paul Lee-Archer, Daniel Boyd, Trung Du, Robert Elliott, Cameron Graydon, Neil Paterson, Lidia Morawska

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In one paragraph

Article in Paediatric anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Paul Lee-ArcherDepartment of Anaesthesia, Queensland Children's Hospital, Brisbane, Queensland, Australia.ORCID 0000-0001-8640-8792
Daniel BoydDepartment of Anaesthesia, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Trung DuDepartment of Anaesthesia, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Robert ElliottDepartment of Anaesthesia, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Cameron GraydonDepartment of Anaesthesia, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Neil PatersonDepartment of Anaesthesia, Queensland Children's Hospital, Brisbane, Queensland, Australia.ORCID 0000-0003-2183-2968
Lidia MorawskaScience and Engineering Faculty, School of Earth & Atmospheric Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBarrier techniques, such as plastic sheets or intubation boxes, are purported to offer additional protection for healthcare workers.

aimsTo assess the functionality, perceived safety, droplet protection, and aerosol protection of several barrier techniques.

methodsFirstly, a simulation study with 12 different laryngoscopists was conducted to assess the time taken to perform an intubation (via direct laryngoscopy, via video laryngoscopy, and via a bougie) with four different barrier techniques (personal protective equipment only, a plastic sheet, a tented plastic sheet, and an intubation box). Secondly, a cough at the time of intubation was simulated using ultraviolet dye to assess the spread of droplets; and thirdly, smoke was used to assess the spread of aerosols.

resultsIntubation time using the box was noninferior to using no barrier. Based on subjective ratings by the laryngoscopists, the most functional technique was no barrier followed by the intubation box, then the tented sheet, and then the plastic sheet. The technique that conferred the highest feeling of safety to the laryngoscopists was the intubation box, followed by the tented sheet, then no barrier, and then the plastic sheet. All the barriers prevented the ultraviolet dye contaminating the head and torso of the laryngoscopist. Smoke remained within the intubation box if plastics sheets were used to cover the openings and suction was ineffective at clearing it. With no barrier in place, smoke was effectively cleared away from the patient in a theater with laminar flow but tended to spread up toward the laryngoscopist in a room without laminar flow.

conclusionsA well-designed intubation box is an effective barrier against droplets and is noninferior to no barrier in relation to intubation time. However, a box interferes with laminar flow in theaters with formal ventilation systems and may result in accumulation of aerosols if it is completely enclosed.

Indexed as

AnestheticsCOVID-19ChildHumansInfectious Disease Transmission, Patient-to-ProfessionalIntubation, IntratrachealSARS-CoV-2Anestheticsairway managementinfection controlpediatricssimulation

Identifiers

PMID33280199

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.