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Perception of level of knowledge, skills, and safety before and after training to perform videolaryngoscopy with the Intubox barrier system for airway management in patients with COVID-19




Adánez Martínez MG, Leal Costa C, García López JA, Torres Ganfornina M, Ramos Morcillo AJ, Hernández Ruipérez T, García Palenciano C, Díaz Agea JL



Servicio de Urgencias Hospitalarias, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, Spain. Facultad de Enfermería, Universidad de Murcia, Spain. Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario Virgen de la Arrixaca, Spain. Servicio de Urgencias Hospitalarias, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad Católica de Murcia (UCAM), Murcia, Spain. Facultad de Enfermería, Universidad Católica de Murcia, Spain.



Objectives. The main objective was to describe physicians’ perception of their knowledge, skill, and safety before and after training to perform videolaryngoscopy while using the Intubox barrier system when managing the airway of a patient with the coronavirus 2019 disease (COVID-19). The secondary objective was to assess the safety afforded by the barrier by means of visually evaluating particle dispersion during intubation.
Methods. Single-arm clinical simulation trial. The participants were physicians who received training in both a low-fidelity and a high-fidelity simulation zone. The participants assessed their knowledge, skill, and safety when using the Intubox before and after training using a specially designed and validated questionnaire. Droplet contamination was estimated visually.
Results. Twenty-seven physicians with a mean (SD) age of 40 (10.8) years participated; 63% were women. They perceived their knowledge, skill, and safety to be significantly higher after training. Droplet contamination was seen to decrease when airway management maneuvers were done with the barrier in place.
Conclusions. After simulation training the emergency physicians judged their knowledge, skill, and safety to be greater when they used the barrier during airway management in patients with COVID-19. The combined use of a laryngoscope and the Intubox barrier resulted in less particle dispersion during intubation.


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