key: cord-0807694-bg1f58em
authors: Lin, Chih-Han; Gan, Connie CR.; Tseng, Yu-Chi; Lee, Kuan-I.; Chen, Wei-Kung; Lee, Feng-You
title: Protection effectiveness of a building-integrated COVID-19 sampling station that uses a sealed acrylic window as a physical barrier
date: 2020-05-11
journal: Ann Emerg Med
DOI: 10.1016/j.annemergmed.2020.05.010
sha: c160fe07806a4bb86d63a3064a4b5424d9ed2e5a
doc_id: 807694
cord_uid: bg1f58em

nan

Dear editor:

Because a healthy and efficient medical workforce is key to containing the present coronavirus disease 2019 (COVID-19) pandemic, the protection of health care workers (HCWs) is paramount. 1, 2 According to the interim guidance for COVID-19 from the World Health Organization(WHO), 3 HCWs must don personal protective equipment (PPE) when sampling a patient who is highly suspected of having pneumonia. Such PPE must include an N95 respirator, a pair of goggles or a face shield, a gown, and a pair of gloves. 4 However, this set of PPE cannot cover all surfaces of the body. Thus, to minimize the risk of exposure to this pathogen, and to conserve PPE, we constructed a building-integrated sampling station. Designed by Tseng Yu-Chi and Tseng Kai-Chen, this station has 1) a sealed acrylic window serving as a physical barrier separating the interior (where the physician is) from the exterior (where the patient is), and 2) a pair of sealed rubber gloves affixed to the station for the physician to perform nasopharyngeal sampling. The exterior (patient side) is thoroughly disinfected before another patient is sampled.

We conducted a simulation in the emergency department of Taichung Tzu Chi Hospital in Taichung, Taiwan on April 20, 2020, to test whether this device can fully protect the physician. A physician was equipped with the full set of WHO-recommended PPE: a fluid-resistant gown, N95 respirator, pair of gloves, pair of goggles, and hair cup and they collected a nasopharyngeal swab sample from a patient face to face ( Figure 1B) . The patient held a sprayer filled with fluorescent agent and sprayed it toward the physician, mimicking the droplets or aerosols produced by a real patient. We then checked where the fluorescent agent landed using a black light. When the station was not used, we found that the fluorescent agent passed through the face shield and settled on the skin of the physician's neck ( Figure  1D ). However, when the station was used, no fluorescent agent was found on the surface of the physician's body ( Figure 1C ). When using our station, the physician was not wearing any PPE and was separated from the patient by the acrylic window.

The physician sampled the patient using the fixed and sealed rubber gloves ( Figure   1A ). In contrast to the absence of fluorescent agent on the physician's body, there was a broad distribution of fluorescent agent on the exterior, such as on the window, desk, and even roof of the station. On the basis of the results of our experiment, we recommend our specially designed, building-integrated sampling station to HCWs who sample face to face at a short distance for patients who are suspected of respiratory infection. Our station conserves PPE and protects HCWs from viral infection. If our station is not available, HCWs should use PPE (preferably with full-body coverage) and thoroughly clean it after taking it off.

The use of personal protective equipment in the COVID-19 pandemic era. The American journal of emergency medicine

Protecting healthcare personnel from 2019-nCoV infection risks: lessons and suggestions

Rational use of personal protective equipment for coronavirus disease (COVID-19): interim guidance

How to Obtain a Nasopharyngeal Swab Specimen