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Detailed characterisation of aerosol quantities, particle size and generating activities has been undertaken in a number of simulations but not in actual clinical practice. The aim of this study was to determine whether the processes of facemask ventilation, tracheal intubation and extubation generate aerosols in clinical practice, and to characterise any aerosols produced. In this observational study, patients scheduled to undergo elective endonasal pituitary surgery without symptoms of COVID\u201019 were recruited. Airway management including tracheal intubation and extubation was performed in a standard positive pressure operating room with aerosols detected using laser\u2010based particle image velocimetry to detect larger particles, and spectrometry with continuous air sampling to detect smaller particles. A total of 482,960 data points were assessed for complete procedures in three patients. Facemask ventilation, tracheal tube insertion and cuff inflation generated small particles 30\u2013300 times above background noise that remained suspended in airflows and spread from the patient\u2019s facial region throughout the confines of the operating theatre. Safe clinical practice of these procedures should reflect these particle profiles. This adds to data that inform decisions regarding the appropriate precautions to take in a real\u2010world setting.<\/jats:p>","DOI":"10.1111\/anae.15301","type":"journal-article","created":{"date-parts":[[2020,10,12]],"date-time":"2020-10-12T22:21:53Z","timestamp":1602541313000},"page":"182-188","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Aerosolisation during tracheal intubation and extubation in an operating theatre setting"],"prefix":"10.1111","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6975-8325","authenticated-orcid":false,"given":"R. S.","family":"Dhillon","sequence":"first","affiliation":[{"name":"Department of Neurosurgery St Vincent's Hospital Melbourne Fitzroy Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. A.","family":"Rowin","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering University of Melbourne Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. S.","family":"Humphries","sequence":"additional","affiliation":[{"name":"Climate Science Centre CSIRO Oceans and Atmosphere Aspendale Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Kevin","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering University of Melbourne Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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A.","family":"Scott","sequence":"additional","affiliation":[{"name":"University of Melbourne and Department of Anaesthesia and Acute Pain Medicine St Vincent's Hospital Melbourne Fitzroy Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Clinical Aerosolisation Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa939"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0035797"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30084-9"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15071"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15144"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-020-01591-x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6627"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15170"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820929274"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2020.05.012"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6633"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a118097"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2010.11.010"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/jfm.2020.330"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1098\/rsif.2013.0560"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0668.2007.00469.x"},{"key":"e_1_2_6_18_1","first-page":"1837","article-title":"Turbulent gas clouds and respiratory pathogen emissions: potential implications for reducing transmission of COVID\u201019","volume":"323","author":"Bourouiba L","year":"2020","journal-title":"Journal of the American Medical Association"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15146"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2007589"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-020-01705-5"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15188"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2004973"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15093"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-6553(98)70046-X"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2006.05.022"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.24171\/j.phrp.2020.11.1.02"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.15301","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anae.15301","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.15301","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T22:41:50Z","timestamp":1761691310000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.15301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,3]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1111\/anae.15301"],"URL":"https:\/\/doi.org\/10.1111\/anae.15301","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,3]]},"assertion":[{"value":"2020-09-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}