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“Aerosol extractor for airway management of COVID-19 patients” by Tomoyuki Saito, Asuka Fujishiro and Takashi Asai deals with an important topic [1]. Continuous oro-tracheal suctioning can minimize exhaled air dispersion during coughing bouts [2]. We liked to highlight two additional protective measures, in particular, the double-C hold in bag-mask ventilation [3] and blanketing the patient with a thin plastic barrier [4]. A good seal for bag-mask ventilation increases efficacy and reduces the risk of contamination with aerosols.
Blanketing the patient with a thin plastic barrier can diminish the risk of contamination from aerosols, vomitus, blood, and body secretions [4]. The foil conforms to the face with a central perforation to ensure air-tight installation of the mask below the shield with filter, valve and bag above. Aerosols from air leakage are removed by adhesion and drainage below the barrier.
References
Saito T, Fujishiro A, Asai T. Aerosol extractor for airway management of COVID-19 patients. J Anesth. 2021;35:323. https://doi.org/10.1007/s00540-021-02916-w.
Chan MTV, Chow BK, Lo T, Ko FW, Ng SS, Gin T, Hui DS. Exhaled air dispersion during bag-mask ventilation and sputum suctioning—implications for infection control. Sci Rep. 2018;8(1):198. https://doi.org/10.1038/s41598-017-18614-1.
Nolan JP, Monsieurs KG, Bossaert L, Böttiger BW, Greif R, Lott C, Madar J, Olasveengen TM, Roehr CC, Semeraro F, Soar J, Van de Voorde P, Zideman DA, Perkins GD; European Resuscitation Council COVID-Guideline Writing Groups. European resuscitation council COVID-19 guidelines executive summary. Resuscitation. 2020;153:45–55. https://doi.org/10.1016/j.resuscitation.2020.06.001.
Matava CT, Yu J, Denning S. Clear plastic drapes may be effective at limiting aerosolization and droplet spray during extubation: implications for COVID-19. Can J Anaesth. 2020;67(7):902–4. https://doi.org/10.1007/s12630-020-01649-w.
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Isser, M., Salchner, H. & Lederer, W. Double-C hold for bag-mask ventilation during resuscitation. J Anesth 36, 158 (2022). https://doi.org/10.1007/s00540-021-02935-7
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DOI: https://doi.org/10.1007/s00540-021-02935-7