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 Table of Contents  
LETTER TO EDITOR
Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 52-53

Intubation of COVID-19 patients with catheter mount and heat and moisture exchanger filter preconnected to endotracheal tube


1 Department of Critical Care Medicine, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Andheri (West), Mumbai, Maharashtra, India
2 Department of Critical Care Medicine, PD Hinduja National Hospital and Medical Research Center, Mahim, Mumbai, Maharashtra, India

Date of Submission04-Nov-2021
Date of Acceptance24-Jan-2022
Date of Web Publication19-Apr-2022

Correspondence Address:
Dr. Sonali Vadi
Department of Critical Care Medicine, Kokilaben Dhirubhai Ambani Hospitaland Medical Research Institute, Andheri (West), Mumbai-400053, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jacp.jacp_56_21

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Keywords: Cross-infection, endotracheal intubation, healthcare worker safety, SARS-CoV-2


How to cite this article:
Vadi S, Tekawade P. Intubation of COVID-19 patients with catheter mount and heat and moisture exchanger filter preconnected to endotracheal tube. J Assoc Chest Physicians 2022;10:52-3

How to cite this URL:
Vadi S, Tekawade P. Intubation of COVID-19 patients with catheter mount and heat and moisture exchanger filter preconnected to endotracheal tube. J Assoc Chest Physicians [serial online] 2022 [cited 2022 Sep 25];10:52-3. Available from: https://www.jacpjournal.org/text.asp?2022/10/1/52/339693



Dear Editor,

In the intensive care unit, intubation is one of aerosol generating procedures posing a risk for severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) transmission.[1] Proximity to the patient’s airway endangers the person performing intubation to cross-infection. Various guidelines recommend[2] use of video-laryngoscope over direct laryngoscope to decrease this risk. Video laryngoscope may not be available in resource limited areas. Put forth is an alternative to reduce intubation-related risk of virus transmission.

Catheter mount and heat and moisture exchanger (HME) filter are usually connected to endotracheal tube, posttracheal intubation. We preconnected endotracheal tube to a catheter mount and HME filter in sequence to achieve a closed circuit. Stylet is inserted through the flip-top-cap-with-a-seal of the mount to ease passage of the endotracheal tube [Figure 1]. Patients are administered sedation and neuromuscular blocking agents to prevent any cough during the procedure. In case of difficult intubation, this assemblage can be railroaded over an intubating bougie. Patients are ventilated and stabilized as needed.
Figure 1 Catheter mount and heat and moisture exchanger filter are connected to endotracheal tube, posttracheal intubation.

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Viral load in a patient’s airway is very high and contagious. Safety of the airway manager performing intubation is provided by facilitating staying as distant from the airway as is possible. Assemblage reduces the risk of cross-infection during intubation, a practical strategy for use in resource-limited settings. Repeated use helps accustom with weight-related concerns of this assemblage. Personal protective equipment should be worn when dealing with high-risk aerosol-generating procedures. Aerosol containment box[3] that acts as a barrier to the viral droplets may additionally be used as per its availability.

Airway manipulation is a prime reason to be infected with the SARS-CoV-2. Refinements in intubating suspected or confirmed patients with coronavirus disease 2019 help in relation to self-protection. This can be implemented in the context of more comprehensive stratagems to avert transmission.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Tran K, Cimon K, Severn M et al. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers. PLoS One 2012;7:e35797.  Back to cited text no. 1
    
2.
Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth 2020;67:568-76.  Back to cited text no. 2
    
3.
Hsu SH, Lai HY, Zabaneh F, Masud FN. Aerosol containment box to the rescue: extra protection for the front line. Emerg Med J 2020;37:400-1.  Back to cited text no. 3
    


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