Comparison of tracheal intubation between sitting position and standing position in COVID-19 patients: A manikin study.

ABSTRACT: It is recommended to use visual laryngoscope for tracheal intubation in a Corona Virus Disease 2019 patient to keep the operator farther from the patient. How the position of the operator affects the distance in this setting is not ascertained. This manikin study compares the distances between the operator and the model and the intubation conditions when the operator is in sitting position and standing position, respectively.Thirty one anesthesiologists with minimum 3-years' work experiences participated in the study. The participant's posture was photographed when he performed tracheal intubation using UE visual laryngoscope in standing and sitting position, respectively. The shortest distance between the model's upper central incisor and operator's face screen (UF), the horizontal distance between the model's upper central incisor and the operator's face screen, the angle between the UF line and the vertical line of the model's upper central incisor were measured. The success rate of intubation, the duration of intubation procedure, the first-attempt success rate, the Cormack-Lehane grade, and operator comfort score were also recorded.When the operator performed the procedure in sitting position, the horizontal distance between the model's upper central incisor and the operator's face screen distance was significantly longer (9.5 [0.0-17.2] vs 24.3 [10.3-33.0], P ≤ .001) and the angle between the UF line and the vertical line of the model's upper central incisor angle was significantly larger (45.2 [16.3-75.5] vs 17.7 [0.0-38.9], P ≤ .001). There was no significant difference in UF distance when the operator changed the position. Cormack-Lehane grade was significantly improved when it was assessed using visual laryngoscope. Cormack-Lehane grade was not significantly different when the operator assessed it in sitting and standing position, respectively. No significant differences were found in the success rate, duration for intubation, first-attempt success rate, and operator comfort score.The operator is kept farther from the patient when he performs intubation procedure in sitting position. Meanwhile, it does not make the procedure more difficult or uncomfortable for the operator, though all the participants prefer to standing position.

A new global method for identifying urban rail transit key station during COVID-19: A case study of Beijing, China.

The rapid-developed COVID-19 has been defined as a global emergency by the World Health Organization. Meanwhile, various evidence indicates there is a positive correlation between the transmission and population density, especially in closed and semi-closed space. The urban rail transit, as one of the major mode choices for people to commute in big cities, carries thousands of passengers every day with relatively closed and limited space, which provides favorable conditions for the spread of the virus. If the surrounding area of any station was disrupted under COVID-19, not only the individual line but also the entire urban rail transit network will have the risk to be affected. Therefore, it is necessary to identify and explore the distribution law of key stations during the spreading process of the COVID-19 virus in the urban rail transit network during the COVID-19 pandemic. Based on the spatial distribution of epidemic area and the demand of urban rail transit passengers, we have proposed a construction method of the rail transit network and use the improved shortest path algorithm to determine the route diversity index of each station which indicates its importance in the urban rail transit network. On this basis, we identify the key stations of the Beijing rail transit network to ensure that passengers avoid high-risk stations during the epidemic. The results show that the number of reasonable routes between any two stations is 1 to 5 during the COVID-19 pandemic. Moreover, the routes diversity index of the Beijing rail transit network was 1.235 during the COVID-19 pandemic and 2.2574 in the normal period. According to the reasonable route diversity index, we have identified the key stations of the Beijing rail transit network during the COVID-19, such as Qi-Li-Zhuang station.

Comparison of Repeated Video Display vs Combined Video Display and Live Demonstration as Training Methods to Healthcare Providers for Donning and Doffing Personal Protective Equipment: A Randomized Controlled Trial.

PURPOSE: The lack of training in personal protective equipment (PPE) donning and doffing is hindering the current fight against the COVID-19 worldwide. In order to enable medical staff to learn how to don and doff PPE faster and more effectively, we compared two training methods of PPE donning and doffing. METHODS: Participants in this study were 48 health care workers randomly divided into two groups. Group A watched a 10-minute demonstration (demo) video four times, while Group B watched the same 10-minute demo video twice and then watched a 10-minute live demo twice. The 40-minute learning time was the same for both groups. A 29-step examination was held after the training was completed. The examination scores of Groups A and B were recorded according to a checklist containing PPE donning and doffing steps . The time spent by the participants on PPE donning and doffing, their satisfaction with the training, and their confidence in donning and doffing PPE accurately were analyzed. RESULTS: The average score of Group B was higher than that Group A, with a mean (SD) of 94.92 (1.72) vs 86.63 (6.34), respectively (P<0.001). The average time spent by Group B was shorter than that spent by Group A, with a mean (SD) of 17.67 (1.01) vs 21.75 (1.82), respectively (P<0.001). The satisfaction and confidence of Group B were higher than those of Group A (P<0.001). CONCLUSION: Compared with repeated video display, combined video display and live demonstration are more suitable training methods for donning and doffing PPE.