Innovation in the airway approach during the COVID-19 pandemic

Background: COVID-19 is predominantly transmitted by droplets, being the risk of infection greatly increased in aerosol-generating procedures, such as intubation, extubation and aspiration of the orotracheal tube. Given the high transmission of this disease, it led to a reorganization of hospital teams and dynamics, with the implementation of additional protection measures. Medical innovation has taken an interesting role in the development of materials that provide protection when approaching the airway. Case: Male patient, 69 years old COVID-19 patient admitted to the Intensive Care Unit (ICU), that complicated with cardiopulmonary arrest. Advanced life support maneuvers with orotracheal intubation was immediately implemented, with recovery. The airway approach was performed using videolaryngoscope and placement of a plastic clamp in the orotracheal tube, only unclamped after connection to the closed circuit of the ventilator. For all these procedures, the aerosol box available at the ICU was used. Summary: The aerossol box and orotracheal tube clamp provided professionals decreases the dispersion of droplets and aerosols, reducing the exposure and consequently the risk of contagion of health professionals. Nevertheless, training and preparation of the staff is necessary in order to enhance the benefits and reduce the difficulties associated with the lack of experience in their use.