ABSTRACT
Learning Objectives: We aim to demonstrate a preferred device to be used for physician protection during the intubation of Covid-19 patients using a simulated model. In addition, we wish to demonstrate which device causes the least interference with the intubation process. Background: With the advent of the SARS-CoV2 (Covid-19) pandemic, there have been significant concerns regarding transmission of the disease to Healthcare Professionals, particularly during intubation procedures. Several forms of barrier protection aimed at decreasing the spread of aerosolized droplets were developed during the early onset of the pandemic. Objectives: Using a simulated airway task trainer, we examined the impact that 3 separate barrier devices had on intubation time and success using both direct and video laryngoscopy. We hypothesized that lighter and more simplistic devices would be preferred and would provide faster intubations. Methods: The subjects of this study comprise of attending level emergency physicians and anesthesiologists employed at a community hospital who were asked to fill out surveys regarding their experience with the barrier devices from previous simulated intubations. In addition, 10 attending level emergency physicians participated in a Just in Time training session in which they performed both direct and video laryngoscopies on an airway task trainer using each of the devices. An independent observer recorded the time it took for each physician to set up the device and to successfully intubate the task trainer. Results: The main results of the survey are depicted in Figure 1a-d. 97 percent of respondents indicated a preference for video laryngoscopy for Covid-19 positive patients. In general, this cohort preferred a plain clear plastic drape or clear plastic drape with PVC cube for direct laryngoscopy and video laryngoscopy set ups (Figure 2a-d). Use of these two devices resulted in significantly faster times to intubation when compared with the fiberglass box. Conclusion: In general, a simple, plastic sheet was the preferred barrier device using video laryngoscopy. Although set up times were faster using the fiberglass box, intubation times were significantly faster using the plastic drape or PVC frame.