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Aerosol box usage has limited benefits in reducing contamination during airway procedures: JAMA
![Aerosol box usage has limited benefits in reducing contamination during airway procedures: JAMA Aerosol box usage has limited benefits in reducing contamination during airway procedures: JAMA](https://medicaldialogues.in/h-upload/2023/05/01/750x450_208617-untitled-design-17.webp)
Canada: According to a new research published in JAMA Network Open,there was significantly less exposure to contamination using an aerosol box than without it; however, this difference between groups was insignificant after doffing personal protective equipment. Using an aerosol box was associated with significantly increased time to successful endotracheal intubation (ETI).
A team of researchers evaluated the effects of a protective aerosol box during airway procedures on exposure to contamination among healthcare workers and time to successful completion of endotracheal intubation (ETI) and laryngeal mask airway insertion.
For reducing healthcare practitioner (HCP) exposure during aerosol-generating medical procedures (AGMPs), aerosol box has been used to manage COVID-19 patients.
The data in this context remains limited, and more research is required effect of aerosol box use on HCP contamination and AGMP procedure time.
Considering this background, researchers did RCT of 61 teams involving 122 participants performing aerosol-generating medical procedures, including 64.8% female and 69.7% physicians.
Participant teams performed three simulated patient scenarios: bag-valve-mask ventilation, ETI, and LMA insertion. Glo Germ generated aerosol during the procedure.
Teams of 2 HCPs were randomly assigned to control (no aerosol box) or intervention groups (aerosol box).
Interventions included an aerosol box or SplashGuard CG, a clear plastic barrier that covers the patient's head and shoulders. It has access ports that enable healthcare professionals to manage the airway.
The surface area of contamination (AOC) on participants was the primary outcome measured.
Here are the summarized results of the study:
- Using an aerosol box decreased AOC to the torso by 77.5%.
- Aerosol box usage decreased AOC to the facial area in airway HCPs by 60.7 %.
- Following doffing personal protective equipment between groups, no statistically significant difference was reported in surface contamination.
- In the aerosol box, the Time to complete ETI was longer compared to a control group, with a mean difference of 10.2 seconds.
- The mean difference for LMA insertion between groups was 2.4 seconds and was insignificant.
When considering aerosol boxes, it's crucial to balance the advantages of reduced surface contamination with the potential negative impact of longer intubation times on patient outcomes.
They said, based on the results of our study, the use of aerosol may be protective against surface contamination before doffing. Still, this effect is insignificant or not maintained after doffing personal protective equipment.
The study has limitations like the impossibility of exactly replicating aerosolization and potential bias.
Further reading:
Cheng A, Pirie J, Lin Y, et al. Aerosol Box Use Reducing Health Care Worker Contamination During Airway Procedures (AIRWAY Study): A Simulation-Based Randomized Clinical Trial. JAMA Netw Open. 2023;6(4):e237894. doi:10.1001/jamanetworkopen.2023.7894
BDS, MDS in Periodontics and Implantology
Dr. Aditi Yadav is a BDS, MDS in Periodontics and Implantology. She has a clinical experience of 5 years as a laser dental surgeon. She also has a Diploma in clinical research and pharmacovigilance and is a Certified data scientist. She is currently working as a content developer in e-health services. Dr. Yadav has a keen interest in Medical Journalism and is actively involved in Medical Research writing.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751