A Rapidly Deployable Negative Pressure Enclosure for Aerosol-Generating Medical Procedures

Am, Chahal; Dewark, Kenneth Van; Gooch, Rebecca; Fukushima, Elisa Akagi; Hudson, Zachary M.

doi:10.1101/2020.04.14.20063958

Cited by 6 publications

(7 citation statements)

References 8 publications

(13 reference statements)

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“…The most common method to assess the device's ability to contain particles or prevent contamination was through the visual assessment of droplets or smoke (71%, n = 39/55), primarily with box systems (51%, n = 20/39). Four studies used the ability to smell [ 78 , 79 ] or taste a bitter solution [ 60 , 80 ] as a proxy for aerosols escaping into the environment. Using these qualitative methods, studies concluded that the use of a barrier device was effective at either preventing or reducing the number of particles escaping the system.…”

Section: Resultsmentioning

confidence: 99%

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

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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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“…SARS-CoV-2 transmission is believed to occur primarily through close contact via respiratory droplets produced during talking, coughing or sneezing (CDC 2020a; WHO 2020). Engineering controls implemented to prevent disease transmission during the COVID-19 pandemic include separation (CDC 2020f; OSHA 2020); novel "intubation boxes" to protect healthcare workers from droplet exposure during aerosol generating procedures such as endotracheal intubations and extubations (Chahal et al 2020;Le et al 2020); and local exhaust source controls such as the ventilated headboard to protect against droplet and aerosol dissemination (CDC 2020c; Dungi et al 2015;Mead et al 2012). With a few exceptions, studies of the effectiveness of intubation boxes and local exhaust source controls are limited, and minimal guidance is available on design dimensions, deployment requirements, and in particular, on the expected performance and limitations of these systems.…”

Section: Covid-19 and The Workplace: Research Questions For The Aerosmentioning

confidence: 99%

Multiparametric optical characterization of airborne dust with single particle extinction and scattering

Cremonesi

Passerini

Tettamanti

et al. 2020

Aerosol Science and Technology

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“…Aerosol containment enclosure (ACE) is a combination of modified intubation box with a provision for negative suction. [ 31 ] It comprises a silicone gasket with arm ports for the main operator and an assistant. The size of the gasket is wide enough to suit a wide range of patients.…”

Section: Introductionmentioning

confidence: 99%

“…ACE with negative pressure has been shown to contain airborne particles in a simulation study. [ 31 ]…”

Section: Introductionmentioning

confidence: 99%

The barrier techniques for airway management in covid-19 patients - review of literature

Yadav

Garg

2021

Journal of Anaesthesiology Clinical Pharmacology

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The coronavirus disease 2019 (COVID-19) has emerged as a pandemic and shall prevail for some time around the globe. The disease can manifest from asymptomatic to severe respiratory compromise requiring airway intervention. Transmission of COVID-19 has been reported to be by droplets, fomites, and aerosols, and airway management is an aerosol-generating procedure. The high viral load in the patient's airway puts the clinician performing intubation at a very high risk of viral load exposure. So, the need for barrier devices was considered and led to reporting of various such devices. All these devices have been reported individually and have not been compared. We present a review of all the information on these devices based on the reported literature.

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A Rapidly Deployable Negative Pressure Enclosure for Aerosol-Generating Medical Procedures

Abstract: Background

Cited by 6 publications

References 8 publications

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

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

Multiparametric optical characterization of airborne dust with single particle extinction and scattering

The barrier techniques for airway management in covid-19 patients - review of literature

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