Novel Coronavirus Disease 2019 (COVID-19) Aerosolization Box: Design Modifications for Patient Safety

Girgis, Alexander M.; Aziz, Merna N; Gopesh, Tilvawala; Friend, James; Grant, Alex; Sandubrae, Jeffrey A; Banks, Dalia A.

doi:10.1053/j.jvca.2020.05.001

Cited by 6 publications

(11 citation statements)

References 3 publications

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“…Box designs were often similar to the original design in Canelli et al [ 7 ], which is a transparent 4-sided structure with two open faces: an inferior face bound by the stretcher and a caudal face pointed towards the foot of the bed. Common modifications included change in the number or size of ports (i.e., for operators and/or tools) [ [8] , [9] , [10] , [11] , [12] ], increased device size for improved operator ergonomics and/or patient body habitus [ [13] , [14] , [15] ], built-in gloves and/or port coverings [ 11 , 12 , 16 , 17 ], addition of a plastic drape or covering on the caudal face [ [18] , [19] , [20] ], a sloped top panel for improved visibility [ 15 , 18 , 21 ] and the use of a negative suction system [ [22] , [23] , [24] ].…”

Section: Resultsmentioning

confidence: 99%

Barrier enclosure use during aerosol-generating medical procedures: A scoping review

Price

Ben-Yakov

Choi

et al. 2021

The American Journal of Emergency Medicine

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Introduction Barrier enclosure devices were introduced to protect against infectious disease transmission during aerosol generating medical procedures (AGMP). Recent discussion in the medical community has led to new designs and adoption despite limited evidence. A scoping review was conducted to characterize devices being used and their performance. Methods We conducted a scoping review of formal databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews, CENTRAL, Scopus), grey literature, and hand-searched relevant journals. Forward and reverse citation searching was completed on included articles. Article/full-text screening and data extraction was performed by two independent reviewers. Studies were categorized by publication type, device category, intended medical use, and outcomes (efficacy – ability to contain particles; efficiency – time to complete AGMP; and usability – user experience). Results Searches identified 6489 studies and 123 met criteria for inclusion (k = 0.81 title/abstract, k = 0.77 full-text). Most articles were published in 2020 (98%, n = 120) as letters/commentaries (58%, n = 71). Box systems represented 42% ( n = 52) of systems described, while plastic sheet systems accounted for 54% ( n = 66). The majority were used for airway management (67%, n = 83). Only half of articles described outcome measures (54%, n = 67); 82% ( n = 55) reporting efficacy, 39% ( n = 26) on usability, and 15% ( n = 10) on efficiency. Efficacy of devices in containing aerosols was limited and frequently dependent on use of suction devices. Conclusions While use of various barrier enclosure devices has become widespread during this pandemic, objective data of efficacy, efficiency, and usability is limited. Further controlled studies are required before adoption into routine clinical practice.

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Section: Resultsmentioning

confidence: 99%

Barrier enclosure use during aerosol-generating medical procedures: A scoping review

Price

Ben-Yakov

Choi

et al. 2021

The American Journal of Emergency Medicine

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“…To the Editor: GIRGIS ET AL. 1 described one of several airway barrier enclosures made in part of transparent plastic sheets of varying stiffness, for placement around the head and upper torso. [1][2][3][4][5][6][7][8][9][10] The benefits and limitations of the barriers are summarized in Table 1 and are discussed here.…”

Section: Benefits and Limitations Of Barrier Enclosures For Airway Proceduresmentioning

confidence: 99%

“…Most of the authors demonstrategd the use of their barriers on mannequins or healthy volunteers who are inside the barrier for brief periods. [1][2][3][4][5][6][7][8][9][10] Many COVID-19 patients requiring an airway procedure are agitated and become claustrophobic inside the barrier. Urgent doffing is required, breaching sterility.…”

Section: Benefits and Limitations Of Barrier Enclosures For Airway Proceduresmentioning

confidence: 99%

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Benefits and Limitations of Barrier Enclosures for Airway Procedures

Jain

2021

Journal of Cardiothoracic and Vascular Anesthesia

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“…The misfortune of non-availability of PPE has led to innovations like barrier protection from aerosols, using the Aerosol Box. [ Figure 1 ][ 2 ] The original aerosol box was created by Dr. Hsien Yung Lai in Taiwan. Literature is replete with evidence that the aerosol box is effective in preventing cough dispersion of infective particles on the care providers.…”

mentioning

confidence: 99%