Use of Plastic Bag to Reduce Risks in Operators During Endotracheal Intubation of Patients With Coronavirus Disease 2019

The rapid spread of coronavirus disease 2019 (COVID-19) has led to a large number of patients being admitted to hospitals, resulting in a near collapse of the medical system. The shortage of negative pressure isolation rooms and personal protective equipment is a potential problem. It is a pressing challenge to prevent the risk of infection in emergency physicians (EPs) during the endotracheal intubation of patients with COVID-19. We used a large clear plastic bag, cut an opening that covered the patient's head, and created a negative pressure environment inside the plastic bag using the hospital's medical gas pipeline system; thus reducing the amount of virus-containing aerosols leaked out and the risk of infection in the operators performing intubation. The video (http://www.caregiver.com.tw/Article.asp?ID=1258#article) about the detailed preparation of the plastic bag intubation kit (PBIK) has been posted on the website. This technique for safe endotracheal intubation in patients with COVID-19 is being used not only by EPs in Taiwan, but also by physicians and paramedics from other countries. Regarding designing the PBIK, our original intention was to use readily available materials to make tools that can improve the safety of the operators performing the intubations in situations where medical resources are exhausted. However, due to limited time and patients, further research is needed for validation.