Intubation may be less risky for doctors than feared

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Placing a tube in a patient’s airway, or removing it, is thought to be one of the highest-risk procedures for medical staff, because of the very close proximity to air being expelled through the mouth of a potentially infected person.

But in operating rooms, at least, these procedures might present less of a risk of virus transmission than has been feared. In operating room experiments in anesthetized patients, intubation and extubation produced far fewer potentially virus-carrying aerosols than expected.

Overall, 19 tube insertions generated about one thousandth of the aerosol generated by a single cough, the researchers reported in the journal Anesthesia.

Fourteen tube removals produced more aerosols, but still less than 25% of that produced by a voluntary cough.

The same might not be true in an emergency room setting. Surgical teams presently wear respirators and high level personal protective equipment to avoid aerosols. After each case, special cleaning is undertaken, which reduces operating room turnover and increases waiting times for operations, the authors say.

The findings call for “reappraisal of what constitutes an aerosol-generating procedure and the associated precautions for routine anesthetic airway management,” they said.

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