Department of Anesthesia & Perioperative Medicine, Western University, London, Canada.
Schulich School of Medicine & Dentistry, Western University, London, Canada.
Korean J Anesthesiol. 2021 Jun;74(3):254-261. doi: 10.4097/kja.20464. Epub 2020 Dec 7.
Protection of healthcare providers (HCP) has been a serious challenge in the management of patients during the coronavirus 2019 (COVID-19) pandemic. Additional physical barriers have been created to enhance personal protective equipment (PPE). In this study, user acceptability of two novel barriers was evaluated and the performance of airway management using PPE alone versus PPE plus the additional barrier were compared.
An open-label, double-armed simulation pilot study was conducted. Each participant performed bag-mask ventilation and endotracheal intubation using a GlideScope in two scenarios: 1) PPE donned, followed by 2) PPE donned plus the addition of either the isolation chamber (IC) or aerosol box (AB). Endotracheal intubation using videolaryngoscopy was timed. Participants completed pre- and post-simulation questionnaires.
Twenty-nine participants from the Department of Anesthesia were included in the study. Pre- and post-simulation questionnaire responses supported the acceptance of additional barriers. There was no significant difference in intubating times across all groups (PPE vs. IC 95% CI, 26.3, 35.1; PPE vs. AB 95% CI, 25.9, 35.5; IC vs. AB 95% CI, 23.6, 39.1). Comparison of post-simulation questionnaire responses between IC and AB showed no significant difference. Participants did not find the additional barriers negatively affected communication, visualization, or maneuverability.
Overall, the IC and AB were comparable, and there was no negative impact on performance under testing conditions. Our study suggests the positive acceptance of additional patient protection barriers by anesthesia providers during airway management.
在 2019 年冠状病毒病（COVID-19）大流行期间，保护医护人员（HCP）一直是患者管理中的一个严峻挑战。已经创建了额外的物理屏障来增强个人防护设备（PPE）。在这项研究中，评估了两种新型屏障的用户可接受性，并比较了仅使用 PPE 与 PPE 加额外屏障进行气道管理的性能。
进行了一项开放标签、双臂模拟试点研究。每个参与者在两种情况下使用 GlideScope 进行袋面罩通气和气管插管：1）穿戴 PPE，然后 2）穿戴 PPE 并增加隔离室（IC）或气溶胶盒（AB）。使用视频喉镜进行气管插管的时间。参与者在模拟前后完成问卷调查。
共有 29 名来自麻醉科的参与者参加了这项研究。模拟前后的问卷调查结果支持对额外屏障的接受。在所有组中，插管时间均无显着差异（PPE 与 IC 的 95%CI，26.3，35.1；PPE 与 AB 的 95%CI，25.9，35.5；IC 与 AB 的 95%CI，23.6，39.1）。比较 IC 和 AB 之间模拟后问卷调查的回复，没有发现显着差异。参与者认为额外的屏障没有对沟通、可视化或可操作性产生负面影响。
总体而言，IC 和 AB 相当，在测试条件下对性能没有负面影响。我们的研究表明，麻醉师在气道管理期间对额外的患者保护屏障有积极的接受度。
