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Exhaled patient derived aerosol dispersion during awake tracheal intubation with concurrent high flow nasal therapy.pdf (2.31 MB)

Exhaled patient derived aerosol dispersion during awake tracheal intubation with concurrent high flow nasal therapy

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journal contribution
posted on 2023-04-06, 08:38 authored by Marc Mac Giolla Eain, Kevin Nolan, Brian Murphy, Conan McCaul, Ronan MacLoughlinRonan MacLoughlin

Awake Tracheal Intubation (ATI) can be performed in cases where there is potential for difficult airway management. It is considered an aerosol generating procedure and is a source of concern to healthcare workers due to the risk of transmission of airborne viral infections, such as SARS-CoV-2. At present, there is a lack of data on the quantities, size distributions and spread of aerosol particles generated during such procedures. This was a volunteer observational study which took place in an operating room of a university teaching hospital. Optical particle sizers were used to provide real time aerosol characterisation during a simulated ATI performed with concurrent high-flow nasal oxygen therapy. The particle sizers were positioned at locations that represented the different locations of clinical staff in an operating room during an ATI. The greatest concentration of patient derived aerosol particles was within 0.5-1.0 m of the subject and along their midline, 2242 #/cm3. As the distance, both radial and longitudinal, from the subject increased, the concentration decreased towards ambient levels, 36.9 ± 5.1 #/cm3. Patient derived aerosol particles < 5 µm in diameter remained entrained in the exhaled aerosol plume and fell to the floor or onto the subject. Patient derived particles > 5 µm in diameter broke away from the exhaled plume and spread radially throughout the operating room. Irrespective of distance and ventilation status, full airborne protective equipment should be worn by all staff when ATI is being performed on patients with suspected viral respiratory infections. 

Funding

Open access funding provided by the IReL Consortium

History

Comments

The original article is available at https://link.springer.com/

Published Citation

Mac Giolla Eain M, Nolan K, Murphy B, McCaul C, MacLoughlin R. Exhaled patient derived aerosol dispersion during awake tracheal intubation with concurrent high flow nasal therapy. J Clin Monit Comput. 2023:1–9.

Publication Date

17 March 2023

PubMed ID

36930390

Department/Unit

  • School of Pharmacy and Biomolecular Sciences

Publisher

Springer

Version

  • Published Version (Version of Record)