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Article: 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

TitleComparison of the Efficiency and Usability of Aerosol Box and Intubation Tent on Intubation of a Manikin Using Personal Protective Equipment: A Randomized Crossover Study
Authors
KeywordsAerosol box
Aerosol
Infection
COVID-19
Manikin, intubation tent
Rapid sequence intubation
Issue Date2021
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jemermed
Citation
The Journal of Emergency Medicine, 2021, v. 61 n. 6, p. 695-704 How to Cite?
AbstractBackground: The aerosol box and intubation tent are improvised barrier-enclosure devices developed during the novel coronavirus pandemic to protect health care workers from aerosol transmission. Objective: Using time to intubation as a crude proxy, we aimed to compare the efficiency and usability of the aerosol box and intubation tent in a simulated manikin. Methods: This was a single-center, randomized, crossover manikin study involving 28 participants (9 anesthetists, 16 emergency physicians, and 3 intensivists). Each participant performed rapid sequence intubations in a random sequence of three different scenarios: 1) no device use; 2) aerosol box; 3) intubation tent. We compared the time to intubation between different scenarios. Results: The median total intubation time with no device use, aerosol box, and intubation tent were 23.7 s (interquartile range [IQR] 19.4–28.4 s), 30.9 s (IQR 24.1–52.5 s), and 26.0 s (IQR 22.1–30.8 s), respectively. Post hoc analysis showed a significantly longer intubation time using the aerosol box compared with no device use (p < 0.001) and compared with the intubation tent (p < 0.001). The difference between the intubation tent and no device use was not significant. The first-pass intubation success rate did not differ between the groups. Only aerosol box use had resulted in breaches of personal protective equipment. Participants considered intubation with the intubation tent more favorable than the aerosol box. Conclusions: The intubation tent seems to have a better barrier-enclosure design than the aerosol box, with a reasonable balance between efficiency and usability. Further evaluation of its efficacy in preventing aerosol dispersal and in human studies are warranted prior to recommendation of widespread adoption.
Persistent Identifierhttp://hdl.handle.net/10722/304213
ISSN
2023 Impact Factor: 1.2
2023 SCImago Journal Rankings: 0.433
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, KW-
dc.contributor.authorLam, RPK-
dc.contributor.authorSin, WC-
dc.contributor.authorIrwin, MG-
dc.contributor.authorRainer, TH-
dc.date.accessioned2021-09-23T08:56:50Z-
dc.date.available2021-09-23T08:56:50Z-
dc.date.issued2021-
dc.identifier.citationThe Journal of Emergency Medicine, 2021, v. 61 n. 6, p. 695-704-
dc.identifier.issn0736-4679-
dc.identifier.urihttp://hdl.handle.net/10722/304213-
dc.description.abstractBackground: The aerosol box and intubation tent are improvised barrier-enclosure devices developed during the novel coronavirus pandemic to protect health care workers from aerosol transmission. Objective: Using time to intubation as a crude proxy, we aimed to compare the efficiency and usability of the aerosol box and intubation tent in a simulated manikin. Methods: This was a single-center, randomized, crossover manikin study involving 28 participants (9 anesthetists, 16 emergency physicians, and 3 intensivists). Each participant performed rapid sequence intubations in a random sequence of three different scenarios: 1) no device use; 2) aerosol box; 3) intubation tent. We compared the time to intubation between different scenarios. Results: The median total intubation time with no device use, aerosol box, and intubation tent were 23.7 s (interquartile range [IQR] 19.4–28.4 s), 30.9 s (IQR 24.1–52.5 s), and 26.0 s (IQR 22.1–30.8 s), respectively. Post hoc analysis showed a significantly longer intubation time using the aerosol box compared with no device use (p < 0.001) and compared with the intubation tent (p < 0.001). The difference between the intubation tent and no device use was not significant. The first-pass intubation success rate did not differ between the groups. Only aerosol box use had resulted in breaches of personal protective equipment. Participants considered intubation with the intubation tent more favorable than the aerosol box. Conclusions: The intubation tent seems to have a better barrier-enclosure design than the aerosol box, with a reasonable balance between efficiency and usability. Further evaluation of its efficacy in preventing aerosol dispersal and in human studies are warranted prior to recommendation of widespread adoption.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jemermed-
dc.relation.ispartofThe Journal of Emergency Medicine-
dc.subjectAerosol box-
dc.subjectAerosol-
dc.subjectInfection-
dc.subjectCOVID-19-
dc.subjectManikin, intubation tent-
dc.subjectRapid sequence intubation-
dc.titleComparison of the Efficiency and Usability of Aerosol Box and Intubation Tent on Intubation of a Manikin Using Personal Protective Equipment: A Randomized Crossover Study-
dc.typeArticle-
dc.identifier.emailWong, KW: kinwa@hku.hk-
dc.identifier.emailLam, RPK: lampkrex@hku.hk-
dc.identifier.emailSin, WC: drwcsin@hku.hk-
dc.identifier.emailIrwin, MG: mgirwin@hku.hk-
dc.identifier.emailRainer, TH: thrainer@hku.hk-
dc.identifier.authorityWong, KW=rp02259-
dc.identifier.authorityLam, RPK=rp02015-
dc.identifier.authoritySin, WC=rp02682-
dc.identifier.authorityIrwin, MG=rp00390-
dc.identifier.authorityRainer, TH=rp02754-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1016/j.jemermed.2021.07.023-
dc.identifier.pmid34511295-
dc.identifier.pmcidPMC8671735-
dc.identifier.scopuseid_2-s2.0-85114688121-
dc.identifier.hkuros325535-
dc.identifier.volume61-
dc.identifier.issue6-
dc.identifier.spage695-
dc.identifier.epage704-
dc.identifier.isiWOS:000732831200017-
dc.publisher.placeUnited States-

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