Impact of Aerosol Box on Duration of Intubation of COVID-19 Patients: Simulation Cross-over Study

COVID-19 outbreak is highly contagious, and healthcare workers are at higher risk of infection particularly with aerosol generating procedures like intubation. Airway management guidelines of COVID-19 patients recommend swift and familiar procedures, while recent reports indicate a safety benefit of using Aerosol Box (AB) during intubation. Aim: Explore the impact of using AB on duration of intubation, and satisfaction of physicians using AB. Design: Crossover simulation study of intubation on a manikin with and without AB. Results: Duration of intubation without AB and with AB was 11.2±3.6 and 18±2.7 seconds respectively (p < 0.001). Most physicians were unsatisfied with using AB in intubation. Conclusion: The protective benefits of AB are not established and validated, while it prolongs time of intubation, and exposes the airway manager to unduly difficulties, which may negatively impact safety.