key: cord-0941580-l2r0iwog
authors: Flanagan, Sarah T.; Ballard, David H.
title: 3D Printed Face Shields: A Community Response to the COVID-19 Global Pandemic
date: 2020-04-17
journal: Acad Radiol
DOI: 10.1016/j.acra.2020.04.020
sha: a4431b675093c67730a630057a83b7202d490fab
doc_id: 941580
cord_uid: l2r0iwog

nan

The evolution of medical 3D printing over the last decade has followed paths of both imagination and problem-solving. Beginning as a novelty with limited practical value, 3D printing has grown to find mainstream uses and acceptance in various industries including engineering, automotive manufacturing, military production, and healthcare. While the diversity of these paths is impressive, we now must merge efforts to meet a collective need. Focused efforts of 3D printing enthusiasts and 3D printing laboratories can help address the critical shortage of personal protective equipment (PPE) during the global COVID-19 pandemic. The purpose of this letter is to discuss the role of 3D printing particularly in the production of face shields, examine its feasibility and adherence under new CDC and FDA pandemic guidelines, and recommend a focused effort by 3D printing hobbyists and industries alike.

Ambitious and imaginative medical professionals saw the potential capabilities of 3D printing early on, sparking a robust medical 3D printing industry that continues to evolve. Current indications for 3D printing include anatomic models and surgical guides for preoperative planning and intraoperative guidance (1). These 3D printing applications, often facilitated by radiology departments, have found success with several applications, such as orthopedic and maxillofacial surgery. There are category III current procedural terminology codes for anatomic models and guides, an effort facilitated by the Radiological Society of North America 3D Printing Special Interest Group and American College of Radiology. However, we as a medical community are now faced with a new collective requirement in the face of the current COVID-19 global pandemic: to protect ourselves despite a critical shortage of PPE.

Healthcare providers across the nation are improvising and rationing, often outside the lines of CDC and FDA guidelines (2) . Healthcare frontliners in NYC have worn trash bags and rain ponchos due to lack of sufficient PPE, and healthcare facilities have distributed policies regarding reuse and rationing of PPE on the frontlines (3, 4) . New CDC and FDA guidelines outline acceptable alternatives and improvisation to the standard PPE within limits. CDC guidelines for contact with COVID-19 patients, readily available from their website, require that eye protection be worn, either goggles or a disposable face shield. While ideally worn with an N95 mask, a face shield and surgical mask are now identified as an acceptable alternative. Usually these face shields are subject to FDA enforcement guidelines, but the FDA has relaxed these guidelines, stating they do not intend to object to the distribution of improvised face shields as long as they create no "undue risk," citing an attempt to help foster greater availability of PPE for the duration of the public health emergency (5) . Requirements for face shields are now bare bones: the products must be labeled as face shields, include a list of the materials which contact the body, and they must not be flammable.

With these new relaxed guidelines, there is a clear role for 3D printed face shields, and we must support and encourage efforts already underway across the nation. Tech companies like Czech-based Prusa Research began sharing open-source face shield designs, allowing anyone with a 3D printer to download and use the free design (6) . Hobbyists who purchased home 3D printers can now churn out a few hundred face shields in a week. On a larger scale, 3D printing industrialists are also turning their efforts to the production of face shields and other PPE. Particularly involved are military and auto industries, with news outlets reporting joint efforts across military branches to work together, pool resources, and determine the scope and volume of 3D printing capabilities (7) . Ford Motor company has facilities all over the country working on 3D printed PPE, including a plant in Plymouth, Michigan producing roughly 1,000,000 face shields per week (8) .

The evolution of 3D printing now must follow a merged path of both imagination and problem-solving in the production of improvised PPE as we collectively face the global pandemic caused by COVID-19. With relaxed guidelines on the regulation of PPE by the FDA, there is a clear need for 3D printed face shields by both hobbyists and developed 3D printing industries alike. 3D printers of the world, please unite together with singular focus: to keep our frontliners safe in our collective fight against COVID-19.

Medical 3D printing cost-savings in orthopedic and maxillofacial surgery: cost analysis of operating room time saved with 3D printed anatomic models and surgical guides

Critical supply shortages -the need for ventilators and personal protective equipment during the COVID-19 pandemic

One hospital's last resort to protect doctors: Yankee Rain Ponchos. The New York Times Website

At War With No Ammo': doctors say shortage of protective gear is dire. The New York Times Website

Enforcement policy for face masks and respirators during the coronavirus disease (COVID-19) public health emergency guidance for industry and food and drug administration staff. Food and Drug Administration Website

People are 3D printing personal protective equipment to help hospitals with shortage. NPR News Website

Military 3D-printing face shields, reusable N95 masks to address hospital shortages. ABC News Website

Ford partners with 3M, GE to make respirators, ventilators and face shields. The Detroit News Website