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Title: Exhaled air dispersion during bag-mask ventilation and sputum suctioning - Implications for infection control.
Authors: Chan MTV
Chow BK
Lo T
Gin T
Hui DS
Keywords: Respiratory Tract Infections/prevention & control
Respiratory Tract Infections/etiology
Respiration, Artificial/methods
Respiratory Tract Infections/transmission*
Source: 8(1):198
Abstract: Mask ventilation and coughing during oro-tracheal suctioning produce aerosols that enhance nosocomial transmission of respiratory infections. We examined the extent of exhaled air dispersion from a human-patient-simulator during mask ventilation by different groups of healthcare workers and coughing bouts. The simulator was programmed to mimic varying severity of lung injury. Exhaled airflow was marked with tiny smoke particles, and highlighted by laser light-sheet. We determined the normalized exhaled air concentration in the leakage jet plume from the light scattered by smoke particles. Smoke concentration ≥20% was considered as significant exposure. Exhaled air leaked from mask-face interface in the transverse plane was most severe (267 ± 44 mm) with Ambu silicone resuscitator performed by nurses. Dispersion was however similar among anesthesiologists/intensivists, respiratory physicians and medical students using Ambu or Laerdal silicone resuscitator, p = 0.974. The largest dispersion was 860 ± 93 mm during normal coughing effort without tracheal intubation and decreased with worsening coughing efforts. Oro-tracheal suctioning reduced dispersion significantly, p < 0.001, and was more effective when applied continuously. Skills to ensure good fit during mask ventilation are important in preventing air leakage through the mask-face interface. Continuous oro-tracheal suctioning minimized exhaled air dispersion during coughing bouts when performing aerosol-generating procedures.
DOI: 10.1038/s41598-017-18614-1
PubMed URL:
Study Name: Re-designing ventilation system for the hospital isolation ward to reduce nosocomial infection
Journal Title: Scientific Reports
Type: Journal Article
Affiliates: The Chinese University of Hong Kong
Study/Trial: Study
Appears in Collections:Scholarly and Clinical

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