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Aerosolisation during tracheal intubation and extubation in an operating theatre setting

Anaesthesia Oct 16, 2020

Dhillon RS, Rowin WA, Humphries RS, et al. - Researchers undertook this observational analysis to determine if the processes of face‐mask ventilation, tracheal intubation and extubation produce aerosols in clinical practice. They sought to characterize any aerosols generated. Participants were patients scheduled to receive elective endonasal pituitary surgery without symptoms of COVID‐19. Airway management was done in a standard positive pressure operating room with aerosols identified employing laser‐based particle image velocimetry to determine larger particles, and spectrometry with continuous air sampling to identify smaller particles. Experts noted that small particles 30–300 times above background noise were produced by face‐mask ventilation, tracheal tube insertion and cuff inflation, and these small particles continued to be suspended in airflows and spread from the patient’s facial region throughout the confines of the operating theatre. These particle profiles should be reflected in safe clinical practice of these procedures. This helps in informing decisions concerning the suitable precautions to take in a real‐world setting.

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