Instruct: Identify the main category of Medrxiv papers based on the titles and abstracts
Query: A Novel Barrier Device and Method for Protection against Airborne Pathogens During Endotracheal Intubation BackgroundThe risk of SARS-CoV-2 transmission to healthcare workers increases during aerosol-generating procedures such as endotracheal intubation.

ObjectivesWe tested the effectiveness of a novel barrier mouthpiece in reducing clinician exposure to aerosols and droplets during endotracheal intubation.

DesignA prospective case control study was carried out, with a single operator performing eight simulated intubations with and without the device on two different high-fidelity manikin models which produced aerosols and droplets.

SettingThe study was performed during June 2020, at the Clinical Skills Development Service, Brisbane, Australia.

InterventionsSimulated scenarios included 1) intubation during cardiopulmonary resuscitation 2) intubation while pre-oxygenating via high flow nasal cannula. Photographic images were obtained during each intubation and digitally analyzed using ImageJ v2.1.0/1.53c.

PatientsNot applicable.

Main outcome measuresAerosol and droplets were quantified using pixel counts. Overall results were expressed as means ({+/-} SD), with comparisons between groups made using a two-tailed Students T-test under the assumption of unequal variances. A P value of [&le;] 0.05 was considered as statistically significant.

ResultsFirst pass intubation was achieved in all scenarios, with and without the barrier device. Pixel counts demonstrated significant overall reduction in aerosol and droplet exposure when the barrier device was used during intubation [Mean (SD) count:509 (860) vs 10169 (11600); P=0.014]. The highest exposure risk to airborne particles was observed during simulated induction, prior to laryngoscopy and intubation.

ConclusionsThe novel barrier device was effective in reducing environmental exposure to aerosols and droplets during intubation without negatively affecting first pass intubation. The highest risk of exposure to airborne particles was during induction, before intubation takes place. Clinical trials are indicated to further test the feasibility and efficacy of this device.

Trial registrationNot applicable.

KEY POINTSO_LIThis prospective, preclinical study represents a pilot trial of a novel barrier mouthpiece for reducing clinician exposure to aerosols and droplets during endotracheal intubation.
C_LIO_LIIn eight simulated intubations with and without the barrier mouthpiece, the device proved effective in reducing environmental exposure to aerosols and droplets (measured in pixels) during intubation, without negatively affecting first pass intubation.
C_LIO_LIThe novel barrier mouthpiece represents a possible solution for reducing the risk of respiratory pathogen transmission during endotracheal intubation without hampering the procedure itself, although larger preclinical and clinical trials are necessary.
C_LI
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