{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T23:03:04Z","timestamp":1788649384152,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":47,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100018468","name":"Tokyo Metropolitan Hiroo Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018468","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tracheal intubation is an aerosol\u2010generating procedure that poses a high risk of infection for healthcare workers. While Level 3 personal protective equipment (PPE) is recommended, its effect on procedural performance remains uncertain. The objective of this study was to evaluate the association among Level 3 PPE use, first\u2010pass success, and adverse events during emergency department (ED) intubation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from the Japanese Emergency Airway Network\u2010V, a multicenter prospective registry of 12 EDs in Japan. Adult patients, aged \u2265\u200918\u2009years, who underwent emergency intubation between 2020 and 2022 were included. Level 3 PPE included disposable gloves, fluid\u2010repellent gowns or coveralls, filtering face piece 3 respirators, and eye protection. The primary outcome was first\u2010pass success, while secondary outcomes included major and minor adverse events, including hypotension, hypoxemia, cardiac arrest, and airway injury. Logistic regression with stabilized inverse probability of treatment weighting was performed to adjust for confounding variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 2431 patients, 1159 (47.7%) were intubated with Level 3 PPE. The unadjusted first\u2010pass success rate was higher with PPE (83.4% vs. 79.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02); however, adjusted first\u2010pass success did not differ significantly (risk difference\u22120.4%, 95% CI\u20136.3 to 5.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.88). After adjustment, major (0.8%, 95% CI\u20137.1 to 8.7) and minor (0.5%, 95% CI\u20132.2 to 3.2) adverse events showed no significant differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of Level 3 PPE was not associated with decreased success or increased adverse events, supporting its safe use during high\u2010risk procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ams2.70121","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T05:15:00Z","timestamp":1771391700000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of Level 3 Personal Protective Equipment With Intubation Success in the Emergency Department"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4790-8281","authenticated-orcid":false,"given":"Haruka","family":"Tsuji","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine International University of Health and Welfare Narita Hospital  Narita Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4616-1729","authenticated-orcid":false,"given":"Takashi","family":"Shiga","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine International University of Health and Welfare Narita Hospital  Narita Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuyo","family":"Chiba","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine International University of Health and Welfare Narita Hospital  Narita Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Fujishima","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine International University of Health and Welfare Narita Hospital  Narita Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9677-6000","authenticated-orcid":false,"given":"Yusuke","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Tokyo Metropolitan Children's Medical Center  Fuchu Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine St. Luke's International Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko","family":"Watase","sequence":"additional","affiliation":[{"name":"Department of Emergency and General Internal Medicine Fujita Health University School of Medicine  Toyoake Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Tokyo Bay Urayasu Ichikawa Medical Center  Urayas Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Emergency and General Internal Medicine Fujita Health University School of Medicine  Toyoake Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakina","family":"Kadomatsu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine International University of Health and Welfare  Narita Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5880-2968","authenticated-orcid":false,"given":"Tadahiro","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Health Data Science, Graduate School of Data Science Yokohama City University  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0035797"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15054"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usx215"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2017.10.047"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.auec.2020.11.003"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2020-209801"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2196\/28366"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437739.71477.ee"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X22001273"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1199750"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2018.10.005"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2018.03.026"},{"issue":"2","key":"e_1_2_10_14_1","first-page":"S201","article-title":"A Prospective, Pragmatic Non\u2010Inferiority Study of Emergency Intubation Success With the Single\u2010Use i\u2010View Versus Standard Reusable Video Laryngoscope","volume":"64","author":"Schauer S. G.","year":"2024","journal-title":"Transfusion"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2301601"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0000000000000535"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr4756"},{"key":"e_1_2_10_18_1","article-title":"Effectiveness of a Simulation\u2010Based Training Program in Improving the Preparedness of Health Care Workers Involved in the Airway Management of COVID\u201019 Patients","volume":"13","author":"Kabi A.","year":"2021","journal-title":"Cureus"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjane.2021.08.017"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2011.11.027"}],"container-title":["Acute Medicine &amp; Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ams2.70121","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ams2.70121","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ams2.70121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T13:07:53Z","timestamp":1772975273000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ams2.70121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/ams2.70121"],"URL":"https:\/\/doi.org\/10.1002\/ams2.70121","archive":["Portico"],"relation":{},"ISSN":["2052-8817","2052-8817"],"issn-type":[{"value":"2052-8817","type":"print"},{"value":"2052-8817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-12-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70121"}}