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Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era

OBJECTIVE: Introduce novel methods and materials to limit microdroplet spread when performing transnasal aerosol generating procedures in the COVID‐19 era. METHODS: Prototypes of a negative pressure face shield (NPFS) were tested then used clinically to create a suction‐clearing negative pressure mi...

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Autores principales: Hoffman, Henry T., Miller, Robert M., Walsh, Jarrett E., Stegall, Helen R., Diekema, Daniel J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444791/
https://www.ncbi.nlm.nih.gov/pubmed/32864444
http://dx.doi.org/10.1002/lio2.437
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author Hoffman, Henry T.
Miller, Robert M.
Walsh, Jarrett E.
Stegall, Helen R.
Diekema, Daniel J.
author_facet Hoffman, Henry T.
Miller, Robert M.
Walsh, Jarrett E.
Stegall, Helen R.
Diekema, Daniel J.
author_sort Hoffman, Henry T.
collection PubMed
description OBJECTIVE: Introduce novel methods and materials to limit microdroplet spread when performing transnasal aerosol generating procedures in the COVID‐19 era. METHODS: Prototypes of a negative pressure face shield (NPFS) were tested then used clinically to create a suction‐clearing negative pressure microenvironment with controlled access to the nose and mouth. Air pressure measurements within prototypes were followed by prospective evaluation of 30 consecutive patients treated with the device assessed through questionnaires and monitoring oximetry. RESULTS: The NPFS is a transparent acrylic barrier with two anterior instrumentation ports and a side port to which continuous suction is applied. It is positioned on a stand and employs a disposable antimicrobial wrap to secure an enclosure around the head. This assembly was successfully used to complete transnasal laryngoscopy in all 30 patients studied. Tolerance of the design was excellent, with postprocedure questionnaire identifying no shortness of breath (27/30), no claustrophobia (27/30), no pain (29/30), and no significant changes in pulse oximetry. CONCLUSION: Diagnostic laryngoscopy was successfully performed in a negative pressure microenvironment created to limit dispersion of aerosols. Further application of the NPFS device is targeted for use with transnasal laryngeal laser and biopsy procedures to be followed by additional modification to enable intranasal and intraoral procedures in a similar protected environment. LEVEL OF EVIDENCE: Level 2b (Cohort Study).
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spelling pubmed-74447912020-08-28 Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era Hoffman, Henry T. Miller, Robert M. Walsh, Jarrett E. Stegall, Helen R. Diekema, Daniel J. Laryngoscope Investig Otolaryngol Laryngology, Speech and Language Science OBJECTIVE: Introduce novel methods and materials to limit microdroplet spread when performing transnasal aerosol generating procedures in the COVID‐19 era. METHODS: Prototypes of a negative pressure face shield (NPFS) were tested then used clinically to create a suction‐clearing negative pressure microenvironment with controlled access to the nose and mouth. Air pressure measurements within prototypes were followed by prospective evaluation of 30 consecutive patients treated with the device assessed through questionnaires and monitoring oximetry. RESULTS: The NPFS is a transparent acrylic barrier with two anterior instrumentation ports and a side port to which continuous suction is applied. It is positioned on a stand and employs a disposable antimicrobial wrap to secure an enclosure around the head. This assembly was successfully used to complete transnasal laryngoscopy in all 30 patients studied. Tolerance of the design was excellent, with postprocedure questionnaire identifying no shortness of breath (27/30), no claustrophobia (27/30), no pain (29/30), and no significant changes in pulse oximetry. CONCLUSION: Diagnostic laryngoscopy was successfully performed in a negative pressure microenvironment created to limit dispersion of aerosols. Further application of the NPFS device is targeted for use with transnasal laryngeal laser and biopsy procedures to be followed by additional modification to enable intranasal and intraoral procedures in a similar protected environment. LEVEL OF EVIDENCE: Level 2b (Cohort Study). John Wiley & Sons, Inc. 2020-07-29 /pmc/articles/PMC7444791/ /pubmed/32864444 http://dx.doi.org/10.1002/lio2.437 Text en © 2020 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Laryngology, Speech and Language Science
Hoffman, Henry T.
Miller, Robert M.
Walsh, Jarrett E.
Stegall, Helen R.
Diekema, Daniel J.
Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era
title Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era
title_full Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era
title_fullStr Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era
title_full_unstemmed Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era
title_short Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era
title_sort negative pressure face shield for flexible laryngoscopy in the covid‐19 era
topic Laryngology, Speech and Language Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444791/
https://www.ncbi.nlm.nih.gov/pubmed/32864444
http://dx.doi.org/10.1002/lio2.437
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