Comparing the Ease of Endotracheal Intubation with and without an Intubation Box in COVID-19 Patients

Nazli Karami; Alireza Mahoori; Tohid Karami; Alireza Shakeri; Dariush Abtahi

doi:10.18502/aacc.v10i3.15688

Nazli Karami Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran.
Alireza Mahoori Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran.
Tohid Karami Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran.
Alireza Shakeri Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Dariush Abtahi Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v10i3.15688

Keywords: Anesthesiologists; COVID-19; Endotracheal intubation; Health personnel; Personal protective equipment; Respiratory aerosols and droplets

Abstract

Background: Endotracheal intubation is a potentially high-risk aerosol-generating procedure. So, an intubation box (I-Box) is designed for personal protection during intubation. This study aimed to compare the outcomes of endotracheal intubation with and without an I-box in COVID-19 patients.

Methods: In this study, 60 COVID-19 patients (30 patients in each group) with and without I-box groups were included. outcomes of intubation including duration of intubation, first-pass success intubation, suitable visibility of airways, restriction of movement in the neck, the need to surface maneuvering of the airway, and the number of attempts for successful intubation were compared between the two groups.

Results: The time of intubation was significantly longer in the I-box group (15.27±2.6 seconds) than without the I-box group (8.37±1.3 seconds) (p<0.001). All patients (100%) were intubated in the first attempt in the without I-box group while the rate of first-pass success intubation was 50% in the I-box group (p <0.001). The visibility of the airway was significantly better in the without I-box group than the I-box group (without I-box: 23 patients (76.7%), I-box: 15 patients (50%), p= 0.032). The frequency of need to optimizing maneuver of the airway was in without and with I-box was 23.3% and 50% respectively (p=0.032).

Conclusion: However, the I-box as a physical barrier can protect healthcare workers but its use increased the time to intubation and the number of attempts for successful intubation and reduced the rate of first-pass success intubation and visibility.