Videolaryngoscopy Intubation in Patients with COVID-19

Abstract

5. Gawande A. Keeping the coronavirus from infecting health-care workers: What Singapore's and Hong Kong's success is teaching us about the pandemic. 2020. Available at: https://www.newyorker.com/news/ news-desk/keeping-the-coronavirus-from-infecting-health-care-workers.

Aerosol boxes and barrier enclosures for airway management in COVID-19 patients: a scoping review and narrative synthesis

“… AB + CPS N/A; report of ‘trials’ (in mannequin? not described) Modification of AB, including CPS proposed for airway management, including extubation, tracheostomy, tube exchange, gastric tube placement, patient transfer Use of AB + CPS for airway management Improved ergonomics, visibility, and room for instrumentation; ramped position possible; side ports; discouraged for emergency, vigilance to avoid PPE disruption Cordier and colleagues 14 Correspondence Clinical report External fixator wrapped with a single-use clear surgical C-arm plastic cover N/A N/A Application of barrier enclosure for tracheostomy and cannula exchange Tracheostomy feasible Zeidan and colleagues 15 Correspondence Case report Plastic AB 1 Case report of single intubation Plastic AB placed after induction, coupled with VLS + bougie Use of bougie associated with increased viral spread; need for protection during intubation Lang and colleagues 16 Correspondence Particles (>0.3 μm) count with and without negative-pressure system Negative-pressure isolation hood (plastic cover + supports + smoke evacuator) One single measurement Experiment description Application of negative-pressure generation within barrier-enclosure system Reduction of 98% of particles: 183 vs 5 min without and with negative pressure, respectively Jain 17 Correspondence Commentary Adjustable frame and CPS + suction system N/A N/A Construction of modified enclosure barrier Missing FDA approval for all models; idea of new adjustable barrier-enclosure system (not described) Kearsley 18 Correspondence Commentary Plastic AB N/A N/A Plastic AB for airway management Criticism for missing limitation of aerosols, patient's fitting, intubation success rate, risk of PPE disruption, and complexity Gould and colleagues 19 Correspondence in response to research letter Simulation study AB N/A Simulation (?) Application of AB …”

“…6,15,42e44,54 The most common barrier-enclosure types were plastic wraps or tents (25 reports), 5,9,12,15,17,23e29,31,33,34,38,39,41,42,44,46,47,52,54,56 acrylic aerosol boxes (19 reports), 4e6,8,11,15,16,18,19,22,24,35,36,43,45,51,53,57,58 and combinations of aerosol boxes and plastic wraps (eight reports). 6,8,13,15,32,37,43,49 Eleven reports included other types of barrier enclosures (modified incubator hood, 7 carton box, 8 acrylic panels, 50 surgical retractors, frames and anaesthetic poles, 21,42,44,48 external fixators, 14 suspension laryngoscopy support, 41,55 and modified packaging tray 40 ). In 10 cases, a smoke evacuator/aspirator was reported.…”

“…5,6,8e11,13,14,17e21,23,25e27,29e31,33,40,41,46,48,52,53,57,58 Cases of barrier-enclosure use with one mannequin or one human were noted in eight reports, 12,15,16,42,50,54,62,63 five cases in three reports, 22,24,44 and series of 25 or more cases in three reports. 37,45,47 The reported settings were simulations with mannequins in 20 cases, 4e6,11e13, 16,19,21e23,25e28,39,41,45,49,60 simulations with study volunteers in two cases, 9,51 use in adult patients in 11 cases, 7,15,23,27,31,37,42,44,47,50,55 and four in paediatric patients. 41,43,52,56 In 24 reports, there was either no setting described or there was a barrier-enclosure description without demonstration.…”

The Anesthesiologist’s Role in Teaching Airway Management to Nonanesthesiologists

“…Similarly, nonanesthesiology trainees in the OR may have less exposure to direct laryngoscopy (DL) if VL is used more often in that program. Most recently, the coronavirus disease (COVID-19) pandemic caused many anesthesiology programs to emphasize VL over DL to increase the distance between the intubator and patient, further reducing the number of DL attempts for trainees [33].…”

Benefits and Limitations of Barrier Enclosures for Airway Procedures

“…Such a barrier is easier to store and dispose of compared with the reusable barriers described. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 …”