Evidence map›Paper›PMID 33619538›Full record

ArticleAnnals of work exposures and health2021

Intubator Performance and Contamination with the Use of Barrier Enclosure Devices: Results from a Simulated COVID-19 Resuscitation.

Maxim Ben-Yakov, Courtney Price, Alia Dharamsi, Davy Tawadrous, Joseph M Choi

Open access · bronzeAbstract read
In one paragraph

Article in Annals of work exposures and health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 32% of its field
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

0 citing papers in PubMed, 4 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Maxim Ben-YakovDivision of Emergency Medicine, Faculty of Medicine, University of Toronto, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.ORCID 0000-0003-1057-3630
Courtney PriceUniversity Health Network, University of Toronto, Toronto, Ontario, University Health Network - Administration, Toronto, ON, Canada.
Alia DharamsiUniversity Health Network, University of Toronto, Toronto, Ontario, University Health Network - Administration, Toronto, ON, Canada.
Davy TawadrousUniversity Health Network, University of Toronto, Toronto, Ontario, University Health Network - Administration, Toronto, ON, Canada.
Joseph M ChoiDivision of Emergency Medicine, Faculty of Medicine, University of Toronto, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
University Health Network · CA

Funding

University Health Network and Mount Sinai Hospital Academic Fund Plan
6 · The paper itself

Abstract

introductionMedical institutions are using barrier enclosure devices during intubation procedures and other aerosol-generating medical procedures without evidence of their effectiveness or usability, potentially compromising patient care, and provider safety. Our objective was to determine the degree of protection offered by these devices and explore other usability factors for two popular barrier systems.

methodsA simulated trial comparing an intubation box, a frame and plastic tarp system, and unprotected intubation was performed in an academic emergency department. Ten emergency physicians were recruited to participate. Our primary outcome was the degree of contamination from secretions measured by average surface area exposed to phosphorescent material. Secondary outcomes included: laryngoscopy time and time to barrier application, unsuccessful intubation attempts, and usability ratings for each system. Descriptive statistics were reported for all variables of interest and a linear mixed model was used to analyze contamination and laryngoscopy time. Usability was captured through electronic questionnaires using a five-point Likert scale.

resultsContamination was more prevalent with the box, compared to the frame and tarp, and no device, however, this did not achieve statistical significance (13.2% versus 8.1% versus 12.2%, P = 0.17). A barrier system delayed intubation when compared to using no system (no system = 24.4 s [95% CI 17.3-27.5], frame = 54.4 s [95% CI 13.8-95.0], box = 33.8 s [95% CI 21.4-46.1], P = 0.02). In assessing usability, 30% of users preferred the use of a box barrier, 40% of users preferred the frame, and 30% would not use either in future intubation.

conclusionsCompared to no barrier protection, an intubation box enclosure offers limited additional protection. A frame and tarp system reduces exposure at the expense of visibility and operator comfort. Finally, barrier systems do not appear to have a clinically significant impact on airway management.

Indexed as

COVID-19Occupational ExposureHumansInfectious Disease Transmission, Patient-to-ProfessionalIntubation, IntratrachealSARS-CoV-2aerosolsbioaerosolsexposure assessmentpenetration through PPEPPE

Identifiers

PMID33619538
PMCPMC7929446
OpenAlexW3131230932

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.