Does the aerosol box accommodate the double-lumen tube intubation?

The aerosol box was widely used to shield healthcare providers from exposure to COVID-19 during single-lumen intubation procedures. However, it has not previously been evaluated for its use in double-lumen tube intubations. This report presents the case of a 25-year-old COVID-19-positive male with a fever who required an emergency thoracotomy for a mediastinal abscess. During the rapid-sequence induction of general anesthesia, an attempt to use the aerosol box for double-lumen tube intubation was made. The attempt faced unique challenges due to the aerosol box's restrictive dimensions and the double-lumen tube's physical characteristics, such as length and flexibility, resulting in an unsuccessful first attempt. Consequently, the aerosol box was removed, and a successful intubation was achieved without it. Postoperatively, the patient remained intubated, was transferred to the intensive care unit, and was extubated on the second postoperative day, followed by intensive care unit discharge. This experience suggests that the standard aerosol box size (50 cm wide, 40 cm deep, and 50 cm tall) may not be suitable for double-lumen tube intubations. This highlights the importance of assessing the feasibility of each aerosol box before its clinical use in such procedures.