Medical training in orotracheal intubation with acrylic box in pediatric SARS-CoV-2 patients decreases exposure time

Introduction: in the SARS-CoV-2 pandemic, the modification of the intubation technique using the aerosol box, in order to reduce exposure to aerosols generates anxiety in Health Workers (HCWs), by increasing the degree of difficulty and time of endotracheal intubation (IT). Simulated intubation environments allow to measured IT and also increase intubation ability and decrease IT. Objective(s): to measure IT pre (without box without training-SS-, with box without training-CS-, with box with training-CC-) and post educational maneuver. Material(s) and Method(s): retrospective, comparative, before and after;with physicians trained in a simulated environment. Result(s): n = 82, age 29 years (27 to 31 years), clinicians 69.5%, residents 82.9%. IT: SS 35 s (27-47.25 s), CS 39.5 s (28-56.5 s) and CC 22 seconds (17.5-30 s), p = 0.0001. Higher IT of clinical vs surgical physicians SS 39 s (30-52 s) versus 32 s (24-34 s), p = 0.004;CS 42 s (33-59 s) versus 28 s (21-43 s), p = 0.016;CC 25 s (20-35 s) versus 19 s (16-21 s) p = 0.018. Higher TI novice vs experienced SS 68 s (39-135 s) versus 34 s (27-46 s), p = 0.058;CS 144 s (84-210 s) versus 38 (28-54 s), p = 0.001, CC 46 s (30-55 s) versus 22 s (17-30 s), p = 0.030. Using the device without training increased IT, but post-training IT decreased in all groups-16 s (-26 to-7 s), which was more noticeable among novices-98 s (-163 to-45.5 s) and the clinical group-18.5 s (-32 to-7 s). Conclusion(s): the use of devices with training can be efficient in terms of IT, regardless the degree of experience and type of medical specialty. Copyright © 2022, Instituto Nacional de Enfermedades Respiratorias. All rights reserved.

Barrier devices during endotracheal intubation: A utility in the intubation process during the sars-cov-2 pandemic?

The urgent need of caring for COVID-19 patients has prompted doctors around the world to come up with innovative strategies to safeguard their health. The response of health care institutions to this pandemic is unprecedented, as is the shortage of personal protective equipment. Without it, the chances of health workers to become ill and die increase. In patients infected with SARS CoV-2, the Aerosol-Generating Procedures are considered to be those with the highest exposure to the virus in the care rooms. In this article we expose the available information regarding additional protection provided by some barrier devices during the intubation-extubation process, in order to create the need for Mexican physicians to investigate the consequences of their use further on. © 2021, Instituto Nacional de Enfermedades Respiratorias. All rights reserved.

Biosecurity and airway management in the pediatric patient with SARS-CoV-2 infection

The first confirmed case of COVID-19 (SARS-CoV-2) in our country occurred on February 27, 2020, according to the Mexican Ministry of Health. The staff engaged in pediatric care has developed training strategies to serve their patients and to be part of the pandemic response staff. Learning biosecurity mechanisms is significant to prevent further spread of the virus and strengthen health care teams with the purpose of preventing contagion. That is why we consider that the pediatricians in Mexico should be trained to determine the type of personal protective equipment and protection strategies before, during and after ventilating patients, also when performing cardiopulmonary resuscitation maneuvers, procedures that are aerosol generators. Considering that a long epidemic is expected in our country, we present this article that serves as part of the knowledge required to document good practices for treating COVID-19.