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2020 ; 75
(10
): 1301-1306
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The impact of respiratory protective equipment on difficult airway management: a
randomised, crossover, simulation study
#MMPMID32335900
Schumacher J
; Arlidge J
; Dudley D
; Sicinski M
; Ahmad I
Anaesthesia
2020[Oct]; 75
(10
): 1301-1306
PMID32335900
show ga
The current international COVID-19 health crisis underlines the importance of
adequate and suitable personal protective equipment for clinical staff during
acute airway management. This study compares the impacts of standard
air-purifying respirators and powered air-purifying respirators during simulated
difficult airway scenarios. Twenty-five anaesthetists carried out four different
standardised difficult intubation drills, either unprotected (control), or
wearing a standard or a powered respirator. Treatment times and wearer comfort
were determined and compared. In the wearer comfort evaluation form, operators
rated mobility, noise, heat, vision and speech intelligibility. All anaesthetists
accomplished the treatment objectives of all study arms without adverse events.
Total mean (SD) intubation times for the four interventions did not show
significant differences between the powered and the standard respirator groups,
being 16.4 (8.6) vs. 19.2 (5.2) seconds with the Airtraq?; 11.4 (3.4) vs. 10.0
(2.1) seconds with the videolaryngoscope; 39.2 (4.5) vs. 40.1 (4.8) seconds with
the fibreoptic bronchoscope scope; and 15.4 (5.7) vs. 15.1 (5.0) seconds for
standard tracheal intubation by direct laryngoscopy, respectively.
Videolaryngoscopy allowed the shortest intubation times regardless of the
respiratory protective device used. Anaesthetists rated heat and vision
significantly higher in the powered respirator group; however, noise levels were
perceived to be significantly lower than in the standard respirator group. We
conclude that standard and powered respirators do not significantly prolong
simulated advanced intubation procedures.