key: cord-1038824-zaab8p2w
authors: Morikawa, Kei; Kida, Hirotaka; Handa, Hiroshi; Inoue, Takeo; Mineshita, Masamichi
title: Evaluation of Droplet Countermeasures by a Particle Visualization System in Simulated Bronchoscopy
date: 2021-03-30
journal: Am J Respir Crit Care Med
DOI: 10.1164/rccm.202009-3430im
sha: 69ec7941c7de6a2ebc5a8fefbd180bf44ce0fc91
doc_id: 1038824
cord_uid: zaab8p2w

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. (A) Face-to-face anesthesia administration using conventional sprayer technique can expose the operator to large amounts of respiratory droplets, especially in the event of coughing. (B) By spraying anesthesia through a pinhole created in a surgical mask, the risk of direct respiratory droplet exposure was greatly reduced. (C) Aerosol generated by nebulizer could be efficiently collected by (D) dental suction machine equipped with a HEPA filter.

Video 1. Pharyngo-anesthesia using conventional sprayer technique.

Video 2. Spraying anesthesia through a pinhole created in a surgical mask. Direct respiratory droplet exposure is greatly reduced, but some fine particle aerosol diffused directly from the surgical mask. Measurements were conducted at a height of 50 cm from a standard (control) mouthpiece, 20 cm from our novel mouthpiece (NMP) technique center hole, 50 cm from the NMP center hole, and 20 cm from the side port of the NMP. The mean (range) particle counts per one cough were 2,900 (91-7,291), 50 (2-108), 0 (0), and 270 (181-425), respectively. Measurements were taken 9 to 10 times from each distance. The NMP technique significantly reduced the dispersion of droplets. Statistical analysis was performed with JMP software. *P , 0.01.

Performing bronchoscopy in times of the COVID-19 pandemic: practice statement from an international expert panel

Bronchoscopy, laryngoscopy, and esophagoscopy during the COVID-19 pandemic

Expert panel consensus statement on the applications and precaution strategies of bronchoscopy in patients with COVID-19

Absoption and scattering of light by small particles

Aerosol generated by nebulizer

Coughing in the supine position with a standard mouthpiece. Video 6. Coughing in the supine position with a novel mouthpiece

The authors thank Shin Nippon Air Technologies Co., Ltd (Tokyo, Japan) for providing the particle visualization system (https://www. snk.co.jp/particle/particle_en.html), Tokyo Giken, Inc. (Tokyo, Japan) for providing an extraoral suction, and Free arm arteo and Boston Scientific Japan K. K. (Tokyo, Japan) for providing an original mouthpiece. The authors also thank Mr. Jason Tonge from St. Marianna University School of Medicine for the linguistic review of this manuscript.