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Aerosolisation during tracheal intubation and extubation in an operating theatre setting.
Dhillon, R S; Rowin, W A; Humphries, R S; Kevin, K; Ward, J D; Phan, T D; Nguyen, L V; Wynne, D D; Scott, D A.
  • Dhillon RS; Department of Neurosurgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Rowin WA; Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria, Australia.
  • Humphries RS; Climate Science Centre, CSIRO Oceans and Atmosphere, Aspendale, Victoria, Australia.
  • Kevin K; Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria, Australia.
  • Ward JD; Climate Science Centre, CSIRO Oceans and Atmosphere, Aspendale, Victoria, Australia.
  • Phan TD; University of Melbourne and Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Nguyen LV; Department of Neurosurgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Wynne DD; Department of Neurosurgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Scott DA; University of Melbourne and Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Anaesthesia ; 76(2): 182-188, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-852200
ABSTRACT
Aerosol-generating procedures such as tracheal intubation and extubation pose a potential risk to healthcare workers because of the possibility of airborne transmission of infection. Detailed characterisation of aerosol quantities, particle size and generating activities has been undertaken in a number of simulations but not in actual clinical practice. The aim of this study was to determine whether the processes of facemask ventilation, tracheal intubation and extubation generate aerosols in clinical practice, and to characterise any aerosols produced. In this observational study, patients scheduled to undergo elective endonasal pituitary surgery without symptoms of COVID-19 were recruited. Airway management including tracheal intubation and extubation was performed in a standard positive pressure operating room with aerosols detected using laser-based particle image velocimetry to detect larger particles, and spectrometry with continuous air sampling to detect smaller particles. A total of 482,960 data points were assessed for complete procedures in three patients. Facemask ventilation, tracheal tube insertion and cuff inflation generated small particles 30-300 times above background noise that remained suspended in airflows and spread from the patient's facial region throughout the confines of the operating theatre. Safe clinical practice of these procedures should reflect these particle profiles. This adds to data that inform decisions regarding the appropriate precautions to take in a real-world setting.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Operating Rooms / Aerosols / Airway Extubation / Intubation, Intratracheal Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Anaesthesia Year: 2021 Document Type: Article Affiliation country: Anae.15301

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Operating Rooms / Aerosols / Airway Extubation / Intubation, Intratracheal Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Anaesthesia Year: 2021 Document Type: Article Affiliation country: Anae.15301