As hospital and health care staff across the country continue learning more about the transmission and spread of COVID-19, caregivers for coronavirus patients continue adapting to the changing needs and best practices for personal protective equipment (PPE).
Now, a new collaborative project from clinicians at Vanderbilt University Medical Center and the Vanderbilt Institute for Surgery and Engineering (VISE) aims to solve one of these critical equipment challenges with a simple, low-cost retrofit solution that improves the safety of intubation boxes.
The intubation box, a four-sided fabricated enclosure used during endotracheal intubation, helps shield a caregiver from being exposed to COVID-19 by containing droplets expelled by the patient during the procedure.
“At the onset of the COVID-19 crisis, there was a lot of interest around a specific box design that proved effective at containing droplets emitted by patients during intubation,” said Rajnish Gupta, MD, associate professor of Anesthesiology at VUMC. “This design gained rapid interest around the world as a means to improve safety. But since, we’ve also learned that these boxes do not offer sufficient protection against aerosols.”
In the first of two video demonstrations published online, Gupta simulates an intubation scenario and shows how the standard COVID-19 intubation boxes fail to contain aerosol smoke and allow it to leak toward the caregiver through the arm holes.
“Even with suction tubing inside of the box designed to clear the smoke, the aerosols are still able to escape, thereby putting clinicians at continued risk of exposure,” added Gupta.
The new solution, created by Gupta and the team at VISE, led by Duke Herrell, MD, professor of Urologic Surgery and professor of Biomedical and Mechanical Engineering, will give clinicians a way to quickly and markedly improve the boxes they already have on hand.
The second video demonstrates the team’s solution: harvesting the sleeves from a disposable surgical gown and attaching them to the arm holes of the intubation box, using acrylic rings and magnets to create a strong seal. This design reduces the gaps that allow aerosol transmission and increases overall protection against infection.
“We designed the solution to be easily attached onto existing intubation boxes, in the hope that this preventative measure can be quickly implemented by hospitals and frontline health care workers,” Herrell said. “These retrofit plans are another example of how, thanks to our team at VISE and the innovators at VUMC, Vanderbilt is well-positioned to tackle these sorts of mission-critical engineering challenges in the healthcare space.”
The research is funded by VISE and the Department of Anesthesiology.