BackgroundThe COVID-19 pandemic has necessitated use of barrier devices, such as goggles and face shields, during endotracheal intubation procedures to protect healthcare professionals. While there is existing research on the efficacy of these devices in simulated environments, there is a lack of published studies comparing their utility in real COVID-19 cases. This randomized crossover study aimed to compare the performance of face shields and goggles during endotracheal intubation in actual COVID-19 cases. MethodsThe study was registered in Clinical Trials Registry of India with registration no. CTRI/2022/07/044114 and was conducted at a tertiary care hospital emergency Operartion theatres (OTs) from May 2022 till March 2023. Experienced airway management professionals participated in the study, with a sample size of 128 participants: using either face shields (Group F) or goggles (Group G). The participants performed intubation attempts using both face shields and goggles in a crossover manner. Subgroups were formed based on whether participants wore medically prescribed spectacles or not. The numerical variables were analyzed by Mann-Whitney U test/Unpaired t-test. The categorical variables were analyzed by Chi-square test/Fischer exact-test. ResultsThe overall intubation time was significantly shorter in face shield group (12.75 ± 1.84 s) compared to the goggles group (14.30 ± 1.96 s) (P < 0.005). Additionally, the time taken for endotracheal tube insertion into the glottis was significantly shorter in the face shield group (3.52 ± 1.22 s) compared to the goggles group (4.26 ± 1.37 s) (P < 0.005). Participants rated the vision and clarity higher in the face shield group (P < 0.001). However, they found face shields to be more claustrophobic compared to goggles (P < 0.001). ConclusionThe study concludes that face shields may offer benefits in terms of faster intubation times, improved vision and clarity, better ergonomics and also more suited for healthcare workers with prescribed spectacles, but potential claustrophobic effects to be kept in mind while selecting protective equipment for healthcare professionals performing intubations.