Impact of the COVID-19 Aerosol Box on the Intubation Success Rate

Introduction The aerosol box was introduced as a protective barrier to reduce healthcare workers' exposure to aerosols during intubation. However, concerns remain regarding its impact on intubation efficiency and patient safety. This study compares intubation success rate, time to tracheal intubation, and intubation difficulty with and without the aerosol box. Methods A randomized controlled trial was conducted on 60 adult patients (ASA I-II, BMI ≤35 kg/m²) undergoing elective surgery under general anesthesia. Participants were randomized into two groups: intubation with an aerosol box (Group A) and intubation without an aerosol box (Group B). Seven experienced anesthesia trainees performed the intubations. The primary outcome was time to successful tracheal intubation. Secondary outcomes included first-pass intubation success, Intubation Difficulty Score (IDS), and issues related to aerosol box usage. Results There were no statistically significant differences in demographic characteristics between the groups. All patients had successful first-pass intubation. The mean intubation time was significantly longer in Group A compared to Group B (30.73 ± 2.9 vs. 23.40 ± 2.0 seconds, p < 0.01). There was no significant difference in intubation difficulty between groups. Common issues encountered with the aerosol box included migration off the bed in five cases (17.2%) and the need for external assistance in five cases (17.2%). The learning curve was comparable among participants. Conclusion Intubation with or without an aerosol box resulted in a 100% first-pass success rate with no significant difference in intubation difficulty. However, the aerosol box significantly increased intubation time.