Pediatric laryngoscopy and bronchoscopy during the COVID-19 pandemic: A four-center collaborative protocol to improve safety with perioperative management strategies and creation of a surgical tent with disposable drapes

Abstract

bronchoscopy during the COVID-19 pandemic: A four-center collaborative protocol to improve safety with perioperative management strategies and creation of a surgical tent with disposable drapes, International Journal of Pediatric Otorhinolaryngology, https://doi.are co-senior authors Running Title: Bronchoscopy during the COVID-19 pandemic.Word Count: 3671 words. Abstract:Aerosolization procedures during the COVID-19 pandemic place all operating room personnel at risk for exposure. We offer detailed perioperative management strategies and present a specific protocol designed to improve safety during pediatric laryngoscopy and bronchoscopy. Several methods of using disposable drapes for various procedures are described, with the goal of constructing a tent around the patient to decrease widespread contamination of dispersed droplets and generated aerosol. The concepts presented herein are translatable to future situations where aerosol generating procedures increase risk for any pathogenic exposure. This protocol is a collaborative effort based on knowledge gleaned from clinical and simulation experience from Children's Hospital Colorado, Children's Hospital of Philadelphia, The Hospital for Sick Children in Toronto, and Boston Children's Hospital.

Protective device to reduce aerosol dispersion in dental clinics during the COVID‐19 pandemic

“…This report describes a novel low-cost device that can be integrated into dental practice, in conjunction with standard PPE, during the COVID-19 pandemic. Although previous studies suggested strategies to reduce aerosol dispersion in various medical areas (Canelli et al 2020, Cubillos et al 2020, Francom et al 2020, the present device seems to be the first aerosol box designed for the dental setting. Of note, considering the remarkably high risks of infection by SARS-CoV-2 during dental practice, the use of this device may contribute to preventing the spread of the virus and help to control the pandemic.…”

“…Various aerosol boxes have been proposed in the medical field (Canelli et al 2020, Cubillos et al 2020, Francom et al 2020. Previous extra-oral dental suction systems have been proposed and commercialized, but none using an aerosol box.…”

“…Recent studies from medical fields suggested using devices to reduce aerosol dispersion (Canelli et al 2020, Cubillos et al 2020, Francom et al 2020, but those did not consider the peculiarities of dentistry, such as the need for constant suction and good visualization of the operative field, since dental procedures require gentle and precise movements. Thus, this study aimed to describe the use of a new protective device to reduce aerosol dispersion in dental clinics during the COVID-19 pandemic, to be used as a low-cost complementary resource in conjunction with standard PPE.…”

Medical Simulation: The Least Advertised and Most Versatile Weapon in Pandemic

“…This marked a historic turning point for simulation practice and might drive its evolution soon. Particular attention was paid to the protection of caregivers ( 7 ), with the development and evaluation of personal protective equipment ( 8 ). Studies reported the use of fluorescence to simulate and visualize droplets generated during airway management procedures, providing a direct visualization under ultraviolet light ( 9 ).…”

In reply: Clear plastic drapes for aerosol-generating medical procedures in COVID-19 patients: questions still remain

“…Our group has since created a modification of the transparent plastic barrier for use during airway surgery and intubation. 4 This enhanced design includes the use of double suction. We showed double suction was effective in removing smoke (a far from perfect human aerosol model) from under the modified transparent drapes.…”