Double-C hold for bag-mask ventilation during resuscitation.

To the Editor:

“Aerosol extractor for airway management of COVID-19 patients” by Tomoyuki Saito, Asuka Fujishiro and Takashi Asai deals with an important topic [1]. Continuous oro-tracheal suctioning can minimize exhaled air dispersion during coughing bouts [2]. We liked to highlight two additional protective measures, in particular, the double-C hold in bag-mask ventilation [3] and blanketing the patient with a thin plastic barrier [4]. A good seal for bag-mask ventilation increases efficacy and reduces the risk of contamination with aerosols.

Blanketing the patient with a thin plastic barrier can diminish the risk of contamination from aerosols, vomitus, blood, and body secretions [4]. The foil conforms to the face with a central perforation to ensure air-tight installation of the mask below the shield with filter, valve and bag above. Aerosols from air leakage are removed by adhesion and drainage below the barrier.