Nonverbal closed loop communication during COVID-19 pandemic - Proposal of four tick technique.

This COVID-19 pandemic has posed difficulty in verbal communication among health-care workers with usage of respirators and personal protective equipments. We propose a four tick technique for the nonverbal closed loop communication in health-care settings with limited resources such as low and middle-income countries. It is simple, easy to learn, train, effective, ensuring patient safety and can be extended to nonhealth-care settings and in electronic form.