Comparison of the Efficiency and Usability of Aerosol Box and Intubation Tent on Intubation of a Manikin Using Personal Protective Equipment: A Randomized Crossover Study.

Abstract Background The aerosol box and intubation tent are improvised barrier-enclosure devices developed during the novel coronavirus pandemic to protect health care workers from aerosol transmission. Objective Using time to intubation as a crude proxy, we aimed to compare the efficiency and usability of the aerosol box and intubation tent in a simulated manikin. Methods This was a single-center, randomized, crossover manikin study involving 28 participants (9 anesthetists, 16 emergency physicians, and 3 intensivists). Each participant performed rapid sequence intubations in a random sequence of three different scenarios: 1) no device use; 2) aerosol box; 3) intubation tent. We compared the time to intubation between different scenarios. Results The median total intubation time with no device use, aerosol box, and intubation tent were 23.7 s (interquartile range [IQR] 19.4–28.4 s), 30.9 s (IQR 24.1–52.5 s), and 26.0 s (IQR 22.1–30.8 s), respectively. Post hoc analysis showed a significantly longer intubation time using the aerosol box compared with no device use (p Conclusions The intubation tent seems to have a better barrier-enclosure design than the aerosol box, with a reasonable balance between efficiency and usability. Further evaluation of its efficacy in preventing aerosol dispersal and in human studies are warranted prior to recommendation of widespread adoption.