Personal protective equipment (PPE) shortages represent a persistent and critical challenge during the COVID-19 pandemic. Communities of 3D printing hobbyists and experts responded by designing and producing homemade, 3D-printed PPE. This report discusses the design, manufacturing and validation of the Kansas City Mask (KC Mask). Once printed and assembled, masks were fit tested at Truman Medical Center in Kansas City, MO. The KC Mask was approved for use by pandemic response administration staff at the hospital. Fortunately, due to adequate PPE supply at the time of this publication, wide utilization of the KC mask has not been required. The authors endorse the KC Mask as a stopgap measure, proven to be effective in situations of critical PPE shortage based on Centers for Disease Control and Prevention (CDC) guidelines.

Personal protective equipment (PPE) shortages persist amidst increasing COVID-19 caseloads. These shortages encouraged some to pursue 3D printing to produce stopgap N95 alternatives. The design presented is an adapter for a commercially available snorkel mask to serve as a full-face respirator, used in dire PPE shortages or in individuals who failed fit testing. Masks were fit tested at The University of Kansas Health System in Kansas City, KS. The mask was fit tested on 22 individuals who previously failed fit testing, and all passed qualitative fit testing with the snorkel mask, adapter and viral filter apparatus. The authors endorse this design as a stopgap measure, proven to be effective in situations of dire PPE shortage or for individuals who have failed fit testing with conventional PPE.

Purpose To describe the clinical course of a patient presenting with unilateral retinopathy after perilesional interferon alpha injections for treatment of ocular surface squamous cell carcinoma. Observations A patient, who was being treated with interferon alpha for ocular squamous cell carcinoma, presented with new onset decreased vision in her left eye. Upon examination, she was found to have cotton wool spots and retinal hemorrhages in the affected eye. Conclusions and Importance Retinopathy is a well-documented side effect of systemic usage of interferon alpha. However, retinopathy has not been well discussed in the scenario of perilesional injections of interferon. It is important for clinicians to monitor for such pathology when using interferon alpha not only systemically, but also locally.

Introduction The shortage of personal protective equipment (PPE) across the country has been widely discussed throughout the COVID-19 pandemic. Unfortunately, recent reports indicate that PPE shortages persist amidst continually increasing caseloads nationwide. Additionally, there have been reports of poor-fitting masks, a problem which is magnified by shortages. The lack of adequate access to conventional N95 masks pushed for some to pursue 3D printing and locally distributing their own manufactured masks as substitutes when PPE, including N95 masks, were not readily available. The design presented, the snorkel mask adapter, is one such design born from the local maker community in partnership with local physicians and hospitals. This article discusses the design, manufacturing, and validation of the snorkel mask adapter and its immediate use in the COVID-19 pandemic as well as future use as stopgap PPE. Methods The design presented is an adapter which can be used with a commercially available snorkel mask in order to serve as a full face respirator in either the case of a PPE shortage or more pertinently for those who are unable to pass fit testing with the available N95 respirators at their respective facilities. Mask components were 3D printed, assembled, and then fit tested by qualitative fit testing (QLFT) at The University of Kansas Health System (TUKHS) in Kansas City, KS as a proof of concept.   Results At TUKHS, the mask was fit tested on 22 individuals who required an N95 mask but were not able to pass qualitative fit testing with the masks available to them at the time. Of the 22 tested, all 22 of them were able to pass QLFT with the snorkel mask, adapter, and viral/bacterial filter combination. Conclusion The results of the fit testing at TUKHS is promising for this N95 alternative. More extensive testing can and should be done, including quantitative fit testing. Persistently increasing caseloads and PPE shortages necessitates an urgent dissemination of these preliminary results. The authors do not advocate for this design as a replacement of traditional N95 masks or other PPE but do endorse this design as a stopgap measure, proven to be effective in situations of dire PPE shortage or for individuals who have failed fit testing with conventional PPE.

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