key: cord-0871603-viddfpev
authors: Liao, Kuei‐Lin; Chen, Mei‐Chun; Cheng, Kuang‐I; Tseng, Kuang‐Yi
title: A variable dimensional aerosol shield provides for perioperative COVID‐19 patients
date: 2021-03-09
journal: Kaohsiung J Med Sci
DOI: 10.1002/kjm2.12377
sha: eadce09bdc52ab4e445413eeaa7a804452157b86
doc_id: 871603
cord_uid: viddfpev

nan

A variable dimensional aerosol shield provides for perioperative COVID-19 patients Coronavirus disease transmissions are mainly through direct exposure to droplets from an infected patient, as a result of coughing, sneezing or other direct contact. 1 Some "devices" have been proposed to protect health care provides by limiting exposure during airway manipulation. Canelli et al. suggested a preformed "aerosol box" to protect clinicians from droplets spreading. But the major limitation of this device is the restricted hand movement during intubation. As a result, this approach has not been as effective during difficult airway management. 2 Utilizing equipment readily available in the operating room, we created a pliable, plastic, transparent, and disposable intubation shield to isolate the airway while allowing manipulation during intubation or at other times during the surgical procedure. The shield was accomplished using the following set-up:

• Two L-shaped stainless anesthesia arms used to secure the "ether screen" (length and height 59 cm) were fixed on each side of the operating room table.

• A transparent plastic bag (PAHSCO sterile cover 1040 mm × 1500 mm, Pacific Hospital Supply Co., Ltd, Taiwan) is placed over the arms and fixed to it with four metal clips to make a 45 × 65 × 50 cm 3 space ( Figure 1(A) ). The plastic bag is placed under anesthesia screens and metal clips fixed the plastic bag on the stainless arms (Figure 1(B) ).

The plastic bag is tucked under the operating table mattress. Two Xshaped holes (diameter: circumference of proximal forearm) are cut in the shield near the anesthetist at about the midclavicular line and a height of about the thoracic sixth to eighth levels (Figure 1(C) ).

• To restrict the infected droplets in the shield following intubation, the contacted gloves and sleeves are sterilized thoroughly with 

Anaesthesia and COVID-19: infection control

Barrier enclosure during endotracheal intubation