An innovative endotracheal tube clamp for use in COVID-19
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CORRESPONDENCE
An innovative endotracheal tube clamp for use in COVID-19 Miguel Jacob, MD . Ernesto Ruivo, MD . Ineˆs Portela, MD . Joa˜o Tavares, MD . Miguel Varela, MD . Sofia Moutinho, MD . Hugo Costa, MD . Daniel Nunez, MD
Received: 1 May 2020 / Revised: 3 May 2020 / Accepted: 3 May 2020 Ó Canadian Anesthesiologists’ Society 2020
To the Editor, The coronavirus disease (COVID-19) pandemic surprised the medical and scientific community because of its characteristic high transmission rate. This has led to the need for reorganization of procedures and the implementation of new approaches to protect medical teams from contamination via aerosols. The latter is of particular importance for those responsible for managing the patient’s airway.1 Other countries (Italy, China, and Spain) have registered a significant number of infected health professionals.2 In addition, during the 2003 severe acute respiratory syndrome (SARS) outbreak in Canada, it was evident that health professionals were at risk of infection, particularly those involved in airway-related
procedures such as endotracheal intubation, extubation, and suctioning.3 Therefore, it is crucial to minimize the risk of aerosol generation when managing the airway and find protective strategies that can be adopted to mitigate it. The emission of aerosols through the endotracheal tube (ETT) is a serious form of exposure to the virus that healthcare professionals should consider. Recommendations advise that the ETT be clamped when not connected to a filtered ventilator circuit to reduce aerosol particle dispersion.4 Herein, we report the use of a disposable clamp (Figure) consisting of a three-dimensional (3D) printed plastic piece that fits around an ETT allowing clamping/unclamping during intubation/extubation and other procedures such as suctioning. Before videolaryngoscope intubation, we insert
M. Jacob, MD (&) I. Portela, MD J. Tavares, MD S. Moutinho, MD Anesthesiology Department, Algarve University and Hospitalar Center, Faro, Portugal e-mail: [email protected]
H. Costa, MD Cardiology Department, Algarve University and Hospitalar Center, Faro, Portugal
Intensive Care Medicine Department, Algarve University and Hospitalar Center, Faro, Portugal
Intensive Care Medicine Department, Algarve University and Hospitalar Center, Faro, Portugal Algarve University and Hospitalar Center, Faro, Portugal
Algarve University and Hospitalar Center, Faro, Portugal E. Ruivo, MD Anesthesiology Department, Algarve University and Hospitalar Center, Faro, Portugal Intensive Care Medicine Department, Algarve University and Hospitalar Center, Faro, Portugal M. Varela, MDD. Nunez, MD Intensive Care Medicine Department, Algarve University and Hospitalar Center, Faro, Portugal Algarve University and Hospitalar Center, Faro, Portugal
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Figure Custom-designed 3D-printed endotracheal tube (ETT) clamp (A) that can be placed on an ETT allowing it to be unclamped (B) and clamped (C) as needed during connection to ventilator circuits and suctioning
the ETT through the d
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