Potential risk analysis of medical staff when performing endotracheal intubation in negative pressure isolation ward

Abstract

This study investigated, using validated computational fluid dynamics techniques, the potential infection risks to medical staff when performing endotracheal intubation in the negative pressure isolation ward during treatment of COVID-19 patients. The research first simulated the airflow distribution in negative pressure isolation ward and then examined the potential infection risks to medical staff under two different respiratory conditions of a patient (i.e. patient with endotracheal intubation and patient with normal respiration). The results revealed that medical staff have high possibility to be contracted when performing endotracheal intubation. Personal protective equipment during endotracheal intubation is thus critical to mitigate the potential infection risk to medical staff. Space position and body posture of the medical staff (e.g. standing upright and bent over) would influence the contamination risk. Higher infection risk was noted for the medical staff who performs endotracheal intubation as compared to the other who delivers assistance. A bent-over posture of the medical staff encounters more particle exposure due to a closer distance to the patient head as well as the unfavourable airflow pattern/direction. Protection by using a plastic aerosol box over the head of the patient was studied, which shows promising improvement by preventing more than 75% of virus particles from spreading around.