Cost-effective canopy protects health workers from COVID-19 infection during ventilation

Photo courtesy of Prof. Yochai Adir.

Healthcare workers are rightly being lauded as heroes as they hunker down on the front lines of treating patients infected with the COVID-19 novel coronavirus. With their efforts come the risk of contracting the virus themselves, but researchers are working on a system that could help protect them from airborne infection.

Professor Yochai Adir, from the Lady Davis Carmel Medical Center Pulmonary Division, Israel, led the research team. They have designed a cost-effective, constant flow plastic canopy system that can help to protect healthcare workers who are at risk of airborne coronavirus infection while delivering non-invasive ventilation or oxygen via high flow nasal cannula (HFNC), according to a research letter published in European Respiratory Journal.

Ventilatory support with non-invasive ventilation or HFNC are often used to treat people with respiratory failure, a symptom of severe coronavirus disease, as they help patients with respiratory difficulties to breathe by pushing pressured air into the lungs via a mask covering the mouth and/or nose.

This can alleviate the need for in-demand, invasive mechanical ventilators, but there are concerns about the increased risk of infection for healthcare workers who treat patients with non-invasive respiratory support.

Since the pandemic has resulted in reduced access to negative pressure facilities and invasive mechanical ventilators, healthcare teams have to adapt, and non-invasive ventilation is one possible way to address the issue. But it can increase the risk of infection among healthcare workers due to mask leakage, patient coughing and the speed and direction of air flow allowing virus particles to become airborne.

The new constant flow canopy system addresses this risk by eliminating healthcare teams' exposure.

WHAT'S THE IMPACT

The flexible plastic canopy forms an air chamber that covers the upper part of the patient's body. The canopy is connected to a system containing a high-quality air filter that cleans the air, and an electrical fan that creates negative pressure, pulling the filtered air to the open air. The canopy system can be used to support up to four patients at a time.

The researchers said the plastic used for the canopy design does not allow fluid or particles to pass through it; it has been tested against international standards, which score effectiveness based on the number and size of airborne particles that pass through the material.

The team installed this system in its hospital and found it supports non-invasive ventilatory support with minimal risk of infection for medical staff, and enables alternatives to mechanical ventilation for those with moderate to severe COVID-19 infection. Those patients may otherwise go untreated due to ongoing equipment shortages.

The physical barrier between patients and medical staff created by the canopy could make administering treatment challenging, and the size of the canopy system can be difficult to install in small treatment rooms, researchers cautioned.

THE LARGER TREND

Addressing ventilator shortages is critical to the fight against COVID-19, but there are a host of other interrelated challenges that must be met. Earlier this month, an Office of the Inspector General report showed that myriad problems -- from ventilator shortages to insufficient tests, slow results and shortages of personal protective equipment – are interconnected, and are making each other worse in a toxic cycle. These various challenges are playing off of each other and exacerbating the situation through a kind of domino effect.

And this phenomenon is widespread. The report claims three out of four hospitals are already treating patients with suspected or confirmed COVID-19.

Critically, it isn't just the ventilators themselves that are scarce. So are the drugs that need to be administered to patients who are placed on these machines. Data recently released by Vizient shows that there are potential shortages of 13 drugs found in three distinct drug classes that are crucial to the use of ventilators. Sedatives and anesthetics, for example, saw a 51% increase in demand during March, while the fill rate has dropped to 63%. Meanwhile, there's been a 67% increase in demand for analgesics, with the fill rate dropping to 73%; and neuromuscular blockers saw a 39% increase in demand, with fill rates dropping to 70%.

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Email the writer: jeff.lagasse@himssmedia.com