Thread by @doctimcook

Out in all its glory the Bristol Aerosol paper

Ready for tonight's debate
This study showing precious few aerosols generated at intubation
@Anaes_Journal @drjulesbrown @TonyPi314 @_andyshrimp

…-publications.onlinelibrary.wiley.com/doi/10.1111/an…

Lots of respiratory aerosols with a voluntary cough

Almost none during intubation sequence - anaesthesia/BMV/suction/intubation

Note the log scale

Not a lot during extubation sequence -
cuff down/extubate/+/-cough/oxygen

Most aerosols are at cough - and extubation cough 1/4 strength of voluntary

Importantly the particle distribution is similar for voluntary and extubation cough
supports respiratory origin

Particle size at 0.3-10 microns also clinically relevant

Here's the numbers

And for a better visual idea of what was done
Here's the cough

https://twitter.com/i/status/1318890563303804928

And here's the intubation

https://twitter.com/i/status/1319171324401668099

Tonight's debate: not a battle to see who wins

Important to explore both methodologies, work together to find common ground
More AGP research is needed: would be great to have several groups with same agreed methodology moving forward, to deliver prompt, clear, relevant results