To Compare Videolaryngoscope Against Direct Laryngoscope for Intubation When Powered Air Purifying Respirator is Worn
NCT ID: NCT04424953
Last Updated: 2021-03-17
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
28 participants
Study Classification
INTERVENTIONAL
Study Start Date
2020-06-01
Study Completion Date
2020-09-25
Brief Summary
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Various guidelines for endotracheal intubation (insertion of breathing tube for mechanical ventilation) of Coronavirus Disease 2019 (COVID-19) patients recommend the use of videolaryngoscope (medical device used for intubation that has a camera to visualize the vocal cords between which the breathing tube will pass) over direct laryngoscope (conventionally-used medical device for intubation that depends on anesthetist's direct visualization of vocal cords). The reasons for this recommendation are to maximize the distance between the medical personnel and the patient's face during intubation to decrease the risk of viral particles transmission and to improve intubation success.
For patients infected with COVID-19, Powered Air Purifying Respirator (PAPR) is recommended as an alternative to N95 masks during aerosol-generating procedures such as intubation because N95 masks may not fully protect medical personnel from viral transmission during intubation.
There is no evidence to suggest that videolaryngoscope (VL) is superior to direct laryngoscope (DL) for intubation when PAPR is donned.
The purpose of this study is to determine if McGrath VL is superior to DL for intubation when the anesthetist is wearing a PAPR. The investigators' hypothesis is that McGrath VL will decrease the time to intubation by 20 seconds and more compared to DL when PAPR is donned. The investigators also hope to learn if there is any difference in the difficulties encountered between the use of VL and DL.
For patients infected with COVID-19, Powered Air Purifying Respirator (PAPR) is recommended as an alternative to N95 masks during aerosol-generating procedures such as intubation because N95 masks may not fully protect medical personnel from viral transmission during intubation.
There is no evidence to suggest that videolaryngoscope (VL) is superior to direct laryngoscope (DL) for intubation when PAPR is donned.
The purpose of this study is to determine if McGrath VL is superior to DL for intubation when the anesthetist is wearing a PAPR. The investigators' hypothesis is that McGrath VL will decrease the time to intubation by 20 seconds and more compared to DL when PAPR is donned. The investigators also hope to learn if there is any difference in the difficulties encountered between the use of VL and DL.
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Detailed Description
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Background:
17% of patients with Coronavirus Disease 2019 (COVID-19) may require endotracheal intubation for mechanical ventilation due to respiratory failure.
Various guidelines for endotracheal intubation of COVID-19 patients recommend the use of videolaryngoscope (VL) over direct laryngoscope (DL). The reasons for this recommendation are to firstly, maximize the distance between the medical personnel and the patient's face during intubation in order to decrease the risk of viral particles transmission and secondly, to improve intubation success.
There is a lack of evidence to show that VL can decrease the risk of contact with aerosol generated during intubation. Matthew T.V. Chan et al have shown that aerosol may be generated up to 45cm away from the patient's face during intubation. In the investigators' own trial run of an experimental set-up to study the difference in intubation between VL and DL when PAPR is worn, the investigators found that it is not possible to maintain a distance of at least 45cm during the intubation process because of the need to visualize the entry of the laryngoscope blade into the patient's mouth in order to prevent injury to the oral structures. The investigators' study is congruent with a recent study that reports the mean distance from the patient's mouth to anesthetist's mouth was 35.6cm using VL and 16.4cm using DL.
In routine intubations, VL is recommended over DL for endotracheal intubation as it may provide a higher success and faster speed of intubation compared to DL. For patients infected with COVID-19, PAPR is recommended as an alternative to N95 masks during aerosol-generating procedures such as intubation because N95 masks may not fully protect medical personnel from viral transmission during intubation. There is currently no evidence to suggest that VL is superior to DL for intubation when PAPR is donned.
Proposed Study Design:
This study will be a randomized controlled trial. Informed consent to take part in the study will be taken from patients who are planned for elective surgery requiring endotracheal intubation and also from a group of anesthetists in the department.
Prior to a consented patient turning up for the operation, randomization will be done to determine who from the selected group of anesthetists will be doing the intubation. The randomly selected anesthetist will wear the PAPR and intubate the patient using either a DL or McGrath VL that the anesthetist is randomized to.
Hypothesis and Objectives:
The hypothesis is that McGrath VL will decrease the time to intubation (TTI) by 20 seconds and more compared to DL when PAPR is donned. The investigators will also study the secondary outcomes between McGrath VL and DL which are first attempt success percentage, use of adjuncts, success or failure at intubation using initial laryngoscope that the anesthetists is randomized to, intubation difficulty scale (IDS), closest distance from patient's mouth to anesthetist's mouth during intubation, adverse events and inability to intubate despite all efforts by the anesthetist.
Sample size calculation:
The primary outcome of this study is the difference in time to complete intubation between DL and VL with hooded PAPR. In a previous study reported by Dong et al in 2013, 21 the median (IQR) time to complete tracheal intubation with suited VL was 18.2 (22.1 - 15.1 = 7.0) seconds, whereas that for suited DL was 26.4 (35.2 - 23.1 = 12.1) seconds.
For a normal distribution, the IQR which covers the middle 50% of the whole distribution is approximately equal to mean +/- 0.6 standard deviation (SD), or equivalently 1.2 SD. If time to complete intubation is normally distributed, the SD for suited VL and suited DL are approximately 5.8 and 10.1 seconds, respectively. To be conservative in calculating the sample size, the larger SD of 10.1 seconds for suited DL is used. Moreover, the distribution of time to complete intubation is unlikely normal but skewed, an inflated SD is assumed to compensate for the violation of normal distribution. Hence, a SD of 18 seconds is used.
The minimal clinically important difference (MCID) for time to complete intubation in comparing different laryngoscopes is not defined in the literature. MCIDs ranging between 10 and 20 seconds to compare intubation times using different laryngoscopes are commonly used, in this study a difference of 20 seconds is assumed. Therefore, to detect a difference of at least 20 seconds between the suited DL and suited VL groups, targeting a power of 80% and a 2-sided type I error of 5%, a sample size of 14 patients is required for each group (that is a total of 28 patients for the study).
The investigators will attempt to recruit 50 patients at the Pre-operative Evaluation Clinic (PEC) to account for a possible drop-out rate of 40% (either from patient refusal to take part in the study on the day of operation or from other unforeseen reasons why earlier-recruited patients will not be taking part in the study).
The investigators will recruit 10 anesthetists from the Division to increase the chance that the randomly selected anesthetist is available on the day of operation for a patient who has consented for the study.
Statistical analysis:
Data will be analyzed with an intention-to-treat analysis. To study the difference in TTI between McGrath VL and DL, the investigators will compare the mean or median time of for intubation with McGrath VL against DL using Mann-Whitney U test or Independent Samples T-test depending on the normality of the distribution.
To study the difference in the first-attempt success rate, use of adjuncts at first attempt, use of adjuncts at subsequent attempts, success or failure at intubation using initial laryngoscope randomized to, adverse events (oxygen desaturation to less than 88%, oro-dental injuries) and inability to intubate despite all measures between McGrath VL and DL, Chi-square test will be used. The investigators will compare the mean or median IDS for McGrath VL against that for DL and the mean or median of the closest distance between the patient's mouth and the anesthetist's mouth during intubation for McGrath VL against that for DL using Mann-Whitney U test or Independent Samples T-test depending on the normality of the distribution.
Quality assurance plan:
All data will be monitored and reviewed by the PI or Co-investigators. Training will be given to the clinical research coordinator for data extraction and entry to the case report forms for analysis will be verified by a second person from the study team. Records for all participants, including case report forms, all source documentation (containing evidence to study eligibility, history and physical findings, laboratory data, results of consultations, etc.) as well as Centralized Institutional Review Board (CIRB) records and other regulatory documentation will be retained by the PI and be accessible for inspection and copying by authorized authorities. The research data will be kept in the secure location within the departmental office for 7 years before being destroyed.
Safety monitoring:
Serious adverse event (SAE) in relation to human biomedical research, means any untoward medical occurrence as a result of any human biomedical research which:
* results in or contributes to death
* is life-threatening
* requires in-patient hospitalization or prolongation of existing hospitalization
* results in or contributes to persistent or significant disability/incapacity or
* results in or contributes to a congenital anomaly/birth defect
* results in such other events as may be prescribed Adverse event (AE) in relation to human biomedical research means any untoward medical occurrence as a result of any human biomedical research which is NOT serious. Adverse event can be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease possibly/ probably/ definitely associated with the participant in the human biomedical research.
Only related SAEs (definitely/ probably/ possibly) will be reported to CIRB. Related means there is a reasonable possibility that the event may have been caused by participation in the research.
The investigator is responsible for informing CIRB after first knowledge that the case qualifies for reporting. Follow-up information will be actively sought and submitted as it becomes available.
Related AEs will not be reported to CIRB. However, the investigator is responsible to keep record of such AEs cases at the Study Site File.
Safety analyses and interim analyses will be done after 14 patients have completed the study to determine the incidence of adverse events. If there are more than 3 patients with adverse events, the investigators will review the safety of the study and decide if there is need to improve on the study design or terminate the study prematurely.
17% of patients with Coronavirus Disease 2019 (COVID-19) may require endotracheal intubation for mechanical ventilation due to respiratory failure.
Various guidelines for endotracheal intubation of COVID-19 patients recommend the use of videolaryngoscope (VL) over direct laryngoscope (DL). The reasons for this recommendation are to firstly, maximize the distance between the medical personnel and the patient's face during intubation in order to decrease the risk of viral particles transmission and secondly, to improve intubation success.
There is a lack of evidence to show that VL can decrease the risk of contact with aerosol generated during intubation. Matthew T.V. Chan et al have shown that aerosol may be generated up to 45cm away from the patient's face during intubation. In the investigators' own trial run of an experimental set-up to study the difference in intubation between VL and DL when PAPR is worn, the investigators found that it is not possible to maintain a distance of at least 45cm during the intubation process because of the need to visualize the entry of the laryngoscope blade into the patient's mouth in order to prevent injury to the oral structures. The investigators' study is congruent with a recent study that reports the mean distance from the patient's mouth to anesthetist's mouth was 35.6cm using VL and 16.4cm using DL.
In routine intubations, VL is recommended over DL for endotracheal intubation as it may provide a higher success and faster speed of intubation compared to DL. For patients infected with COVID-19, PAPR is recommended as an alternative to N95 masks during aerosol-generating procedures such as intubation because N95 masks may not fully protect medical personnel from viral transmission during intubation. There is currently no evidence to suggest that VL is superior to DL for intubation when PAPR is donned.
Proposed Study Design:
This study will be a randomized controlled trial. Informed consent to take part in the study will be taken from patients who are planned for elective surgery requiring endotracheal intubation and also from a group of anesthetists in the department.
Prior to a consented patient turning up for the operation, randomization will be done to determine who from the selected group of anesthetists will be doing the intubation. The randomly selected anesthetist will wear the PAPR and intubate the patient using either a DL or McGrath VL that the anesthetist is randomized to.
Hypothesis and Objectives:
The hypothesis is that McGrath VL will decrease the time to intubation (TTI) by 20 seconds and more compared to DL when PAPR is donned. The investigators will also study the secondary outcomes between McGrath VL and DL which are first attempt success percentage, use of adjuncts, success or failure at intubation using initial laryngoscope that the anesthetists is randomized to, intubation difficulty scale (IDS), closest distance from patient's mouth to anesthetist's mouth during intubation, adverse events and inability to intubate despite all efforts by the anesthetist.
Sample size calculation:
The primary outcome of this study is the difference in time to complete intubation between DL and VL with hooded PAPR. In a previous study reported by Dong et al in 2013, 21 the median (IQR) time to complete tracheal intubation with suited VL was 18.2 (22.1 - 15.1 = 7.0) seconds, whereas that for suited DL was 26.4 (35.2 - 23.1 = 12.1) seconds.
For a normal distribution, the IQR which covers the middle 50% of the whole distribution is approximately equal to mean +/- 0.6 standard deviation (SD), or equivalently 1.2 SD. If time to complete intubation is normally distributed, the SD for suited VL and suited DL are approximately 5.8 and 10.1 seconds, respectively. To be conservative in calculating the sample size, the larger SD of 10.1 seconds for suited DL is used. Moreover, the distribution of time to complete intubation is unlikely normal but skewed, an inflated SD is assumed to compensate for the violation of normal distribution. Hence, a SD of 18 seconds is used.
The minimal clinically important difference (MCID) for time to complete intubation in comparing different laryngoscopes is not defined in the literature. MCIDs ranging between 10 and 20 seconds to compare intubation times using different laryngoscopes are commonly used, in this study a difference of 20 seconds is assumed. Therefore, to detect a difference of at least 20 seconds between the suited DL and suited VL groups, targeting a power of 80% and a 2-sided type I error of 5%, a sample size of 14 patients is required for each group (that is a total of 28 patients for the study).
The investigators will attempt to recruit 50 patients at the Pre-operative Evaluation Clinic (PEC) to account for a possible drop-out rate of 40% (either from patient refusal to take part in the study on the day of operation or from other unforeseen reasons why earlier-recruited patients will not be taking part in the study).
The investigators will recruit 10 anesthetists from the Division to increase the chance that the randomly selected anesthetist is available on the day of operation for a patient who has consented for the study.
Statistical analysis:
Data will be analyzed with an intention-to-treat analysis. To study the difference in TTI between McGrath VL and DL, the investigators will compare the mean or median time of for intubation with McGrath VL against DL using Mann-Whitney U test or Independent Samples T-test depending on the normality of the distribution.
To study the difference in the first-attempt success rate, use of adjuncts at first attempt, use of adjuncts at subsequent attempts, success or failure at intubation using initial laryngoscope randomized to, adverse events (oxygen desaturation to less than 88%, oro-dental injuries) and inability to intubate despite all measures between McGrath VL and DL, Chi-square test will be used. The investigators will compare the mean or median IDS for McGrath VL against that for DL and the mean or median of the closest distance between the patient's mouth and the anesthetist's mouth during intubation for McGrath VL against that for DL using Mann-Whitney U test or Independent Samples T-test depending on the normality of the distribution.
Quality assurance plan:
All data will be monitored and reviewed by the PI or Co-investigators. Training will be given to the clinical research coordinator for data extraction and entry to the case report forms for analysis will be verified by a second person from the study team. Records for all participants, including case report forms, all source documentation (containing evidence to study eligibility, history and physical findings, laboratory data, results of consultations, etc.) as well as Centralized Institutional Review Board (CIRB) records and other regulatory documentation will be retained by the PI and be accessible for inspection and copying by authorized authorities. The research data will be kept in the secure location within the departmental office for 7 years before being destroyed.
Safety monitoring:
Serious adverse event (SAE) in relation to human biomedical research, means any untoward medical occurrence as a result of any human biomedical research which:
* results in or contributes to death
* is life-threatening
* requires in-patient hospitalization or prolongation of existing hospitalization
* results in or contributes to persistent or significant disability/incapacity or
* results in or contributes to a congenital anomaly/birth defect
* results in such other events as may be prescribed Adverse event (AE) in relation to human biomedical research means any untoward medical occurrence as a result of any human biomedical research which is NOT serious. Adverse event can be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease possibly/ probably/ definitely associated with the participant in the human biomedical research.
Only related SAEs (definitely/ probably/ possibly) will be reported to CIRB. Related means there is a reasonable possibility that the event may have been caused by participation in the research.
The investigator is responsible for informing CIRB after first knowledge that the case qualifies for reporting. Follow-up information will be actively sought and submitted as it becomes available.
Related AEs will not be reported to CIRB. However, the investigator is responsible to keep record of such AEs cases at the Study Site File.
Safety analyses and interim analyses will be done after 14 patients have completed the study to determine the incidence of adverse events. If there are more than 3 patients with adverse events, the investigators will review the safety of the study and decide if there is need to improve on the study design or terminate the study prematurely.
Conditions
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Coronavirus Infection
Ventilatory Failure
Anesthesia Intubation Complication
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Randomized controlled trial. Prior to a consented patient turning up for his/her operation, randomization will be done to determine who from the selected group of anesthetists will be doing the intubation. The randomly selected anesthetist will wear the PAPR and intubate the patient using either a DL or McGrath VL that he/she is randomized to.
Primary Study Purpose
TREATMENT
Blinding Strategy
DOUBLE
Participants
Outcome Assessors
The patients who have consented for the operation will not know which laryngoscope (either McGrath videolaryngoscope or direct laryngoscope) was used for their intubation. The outcomes assessor will not know which group the patients and the anesthetists are in when analysing the results.
Study Groups
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McGrath videolaryngoscope
Anesthetists randomized to this group will intubate patients using the McGrath videolaryngoscope
Group Type
ACTIVE_COMPARATOR
McGrath videolaryngoscope
Intervention Type
DEVICE
A brand of a commonly-used videolaryngoscope which has a camera at the end of the laryngoscope to visualize the vocal cords
Direct laryngoscope
Anesthetists randomized to this group will intubate patients using the direct laryngoscope
Group Type
ACTIVE_COMPARATOR
Direct laryngoscope
Intervention Type
DEVICE
Classic direct laryngoscope that depends on visualization of the vocal cords by the operator
Interventions
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McGrath videolaryngoscope
A brand of a commonly-used videolaryngoscope which has a camera at the end of the laryngoscope to visualize the vocal cords
Intervention Type
DEVICE
Direct laryngoscope
Classic direct laryngoscope that depends on visualization of the vocal cords by the operator
Intervention Type
DEVICE
Eligibility Criteria
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Inclusion Criteria
Patients will be undergoing routine pre-anesthesia assessment (including review of medical conditions and airway anatomy) by the anesthetists in the PEC prior to their planned elective surgeries. During their routine pre-anesthesia assessment, they will also be assessed by a study team member to confirm if they meet the eligibility criteria. If they are eligible for enrollment, a qualified practitioner will take informed consent.
We will also recruit 10 anesthetists from the Division to perform the intubations. The 10 anaesthetists will have to self-report experience in both the use of McGrath videolaryngoscope (VL) and direct laryngoscope (DL) for intubation (at least 20 successful intubations with McGrath VL or DL).
* 21 years old and above
* Not pregnant
* ASA physical status I, II and III
* BMI less than 35kg/m2
* Elective surgical operations requiring general anesthesia and endotracheal intubation
* Able to give own informed consent
* No features of difficult airway which has to consist all of the following:
* Class I and II on the modified Mallampati classification
* Thyromental distance of 6.5cm and above
* Mouth opening of 3.5cm and above
* Sterno-mental distance of 12.5cm and above
* Qualified anesthetists (associate consultants and above)
* Experience with both the use of McGrath VL and DL for intubation (at least 20 successful intubations using McGrath VL)
* Willing to perform intubation with PAPR donned and using either the McGrath VL or DL
We will also recruit 10 anesthetists from the Division to perform the intubations. The 10 anaesthetists will have to self-report experience in both the use of McGrath videolaryngoscope (VL) and direct laryngoscope (DL) for intubation (at least 20 successful intubations with McGrath VL or DL).
* 21 years old and above
* Not pregnant
* ASA physical status I, II and III
* BMI less than 35kg/m2
* Elective surgical operations requiring general anesthesia and endotracheal intubation
* Able to give own informed consent
* No features of difficult airway which has to consist all of the following:
* Class I and II on the modified Mallampati classification
* Thyromental distance of 6.5cm and above
* Mouth opening of 3.5cm and above
* Sterno-mental distance of 12.5cm and above
* Qualified anesthetists (associate consultants and above)
* Experience with both the use of McGrath VL and DL for intubation (at least 20 successful intubations using McGrath VL)
* Willing to perform intubation with PAPR donned and using either the McGrath VL or DL
Exclusion Criteria
* Below 21 years old
* Pregnancy
* ASA status IV and above
* Poorly-controlled cardiorespiratory conditions (such as poorly-controlled asthma with Asthma Control Test ≤ 19, chronic obstructive pulmonary disease GOLD 2 and above, exertional angina, coronary artery disease with active symptoms, heart failure with New York Heart Association Class III and above)
* Body Mass Index ≥ 35 kg/m2
* Emergency operation
* Unable to give own consent
* Any feature of difficult airway which is
* Class III and IV on the Modified Mallampati Classification
* Thyromental distance less than 6.5cm
* Mouth opening less than 3.5cm
* Sterno-mental distance less than 12.5cm
* History of difficult intubation
* Unstable cervical spine
* Non-specialist anesthetist
* Inexperience with both the use of McGrath VL and DL for intubation (less than 20 successful intubations using McGrath VL)
* Unwilling to perform intubation with PAPR donned using either the McGrath VL or DL
* Pregnancy
* ASA status IV and above
* Poorly-controlled cardiorespiratory conditions (such as poorly-controlled asthma with Asthma Control Test ≤ 19, chronic obstructive pulmonary disease GOLD 2 and above, exertional angina, coronary artery disease with active symptoms, heart failure with New York Heart Association Class III and above)
* Body Mass Index ≥ 35 kg/m2
* Emergency operation
* Unable to give own consent
* Any feature of difficult airway which is
* Class III and IV on the Modified Mallampati Classification
* Thyromental distance less than 6.5cm
* Mouth opening less than 3.5cm
* Sterno-mental distance less than 12.5cm
* History of difficult intubation
* Unstable cervical spine
* Non-specialist anesthetist
* Inexperience with both the use of McGrath VL and DL for intubation (less than 20 successful intubations using McGrath VL)
* Unwilling to perform intubation with PAPR donned using either the McGrath VL or DL
Minimum Eligible Age
21 Years
Maximum Eligible Age
99 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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Duke-NUS Graduate Medical School
OTHER
Sponsor Role
collaborator
Singapore General Hospital
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Qing Yuan Goh, M.Med (Anes)
Role: PRINCIPAL_INVESTIGATOR
Singapore General Hospital
Locations
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Singapore General Hospital
Singapore, , Singapore
Site Status
Countries
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Singapore
References
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Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3. Epub 2020 Mar 11.
Reference Type
RESULT
Brewster DJ, Chrimes N, Do TB, Fraser K, Groombridge CJ, Higgs A, Humar MJ, Leeuwenburg TJ, McGloughlin S, Newman FG, Nickson CP, Rehak A, Vokes D, Gatward JJ. Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. Med J Aust. 2020 Jun;212(10):472-481. doi: 10.5694/mja2.50598. Epub 2020 May 1.
Reference Type
RESULT
Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth. 2020 May;67(5):568-576. doi: 10.1007/s12630-020-01591-x. Epub 2020 Feb 12.
Reference Type
RESULT
Zuo MZ, Huang YG, Ma WH, Xue ZG, Zhang JQ, Gong YH, Che L; Chinese Society of Anesthesiology Task Force on Airway Management; Airway Management Chinese Society of Anesthesiology Task Force on. Expert Recommendations for Tracheal Intubation in Critically ill Patients with Noval Coronavirus Disease 2019. Chin Med Sci J. 2020 Feb 27;35(2):105-9. doi: 10.24920/003724. Online ahead of print.
Reference Type
RESULT
Cook TM, El-Boghdadly K, McGuire B, McNarry AF, Patel A, Higgs A. Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists. Anaesthesia. 2020 Jun;75(6):785-799. doi: 10.1111/anae.15054. Epub 2020 Apr 1.
Reference Type
RESULT
Chan MT, Chow BK, Chu L, Hui DS. Mask ventilation and dispersion of exhaled air. Am J Respir Crit Care Med. 2013 Apr 1;187(7):e12-4. doi: 10.1164/rccm.201201-0137im. No abstract available.
Reference Type
RESULT
Hall D, Steel A, Heij R, Eley A, Young P. Videolaryngoscopy increases 'mouth-to-mouth' distance compared with direct laryngoscopy. Anaesthesia. 2020 Jun;75(6):822-823. doi: 10.1111/anae.15047. Epub 2020 Mar 29. No abstract available.
Reference Type
RESULT
Lewis SR, Butler AR, Parker J, Cook TM, Smith AF. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. Cochrane Database Syst Rev. 2016 Nov 15;11(11):CD011136. doi: 10.1002/14651858.CD011136.pub2.
Reference Type
RESULT
Scales DC, Green K, Chan AK, Poutanen SM, Foster D, Nowak K, Raboud JM, Saskin R, Lapinsky SE, Stewart TE. Illness in intensive care staff after brief exposure to severe acute respiratory syndrome. Emerg Infect Dis. 2003 Oct;9(10):1205-10. doi: 10.3201/eid0910.030525. No abstract available.
Reference Type
RESULT
Loeb M, McGeer A, Henry B, Ofner M, Rose D, Hlywka T, Levie J, McQueen J, Smith S, Moss L, Smith A, Green K, Walter SD. SARS among critical care nurses, Toronto. Emerg Infect Dis. 2004 Feb;10(2):251-5. doi: 10.3201/eid1002.030838.
Reference Type
RESULT
Nouruzi-Sedeh P, Schumann M, Groeben H. Laryngoscopy via Macintosh blade versus GlideScope: success rate and time for endotracheal intubation in untrained medical personnel. Anesthesiology. 2009 Jan;110(1):32-7. doi: 10.1097/ALN.0b013e318190b6a7.
Reference Type
RESULT
Altun D, Ali A, Camci E, Ozonur A, Seyhan TO. Haemodynamic Response to Four Different Laryngoscopes. Turk J Anaesthesiol Reanim. 2018 Dec;46(6):434-440. doi: 10.5152/TJAR.2018.59265. Epub 2018 Sep 6.
Reference Type
RESULT
Adnet F, Borron SW, Racine SX, Clemessy JL, Fournier JL, Plaisance P, Lapandry C. The intubation difficulty scale (IDS): proposal and evaluation of a new score characterizing the complexity of endotracheal intubation. Anesthesiology. 1997 Dec;87(6):1290-7. doi: 10.1097/00000542-199712000-00005.
Reference Type
RESULT
Roth D, Pace NL, Lee A, Hovhannisyan K, Warenits AM, Arrich J, Herkner H. Bedside tests for predicting difficult airways: an abridged Cochrane diagnostic test accuracy systematic review. Anaesthesia. 2019 Jul;74(7):915-928. doi: 10.1111/anae.14608. Epub 2019 Mar 6.
Reference Type
RESULT
Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia. 1984 Nov;39(11):1105-11.
Reference Type
RESULT
Greenland KB, Tsui D, Goodyear P, Irwin MG. Personal protection equipment for biological hazards: does it affect tracheal intubation performance? Resuscitation. 2007 Jul;74(1):119-26. doi: 10.1016/j.resuscitation.2006.11.011. Epub 2007 Mar 13.
Reference Type
RESULT
Shin DH, Choi PC, Na JU, Cho JH, Han SK. Utility of the Pentax-AWS in performing tracheal intubation while wearing chemical, biological, radiation and nuclear personal protective equipment: a randomised crossover trial using a manikin. Emerg Med J. 2013 Jul;30(7):527-31. doi: 10.1136/emermed-2012-201463.
Reference Type
RESULT
Related Links
Access external resources that provide additional context or updates about the study.
https://www.apsf.org/news-updates/perioperative-considerations-for-the-2019-novel-coronavirus-covid-19/
Liana Zucco, Nadav Levy, Desire Ketchandji, Mike Aziz, S. K. R. Anesthesia Patient Safety Foundation - Perioperative Considerations for the 2019 Novel Coronavirus (COVID-19)
https://asa.org.au/covid-19-updates/
Australian Society of Anaesthetists. COVID-19 Updates.
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
2020/2329
Identifier Type: -
Identifier Source: org_study_id
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