Modified Barrier Enclosure for Noninvasive Respiratory Support in COVID-19 Outbreak

AIM: To develop a device that can reduce the exposure of aerosols to healthcare workers (HCWs) who are working in coronavirus disease-2019 (COVID-19) critical units. BACKGROUND: Barrier enclosure has recently been proposed for use during intubations where the risk of aerosolization is high. In COVID-19 outbreak, use of noninvasive respiratory support is increasing. But at the same time, it is associated with high risk of aerosol generation, leading to infections among HCWs. We have made a modification in the intubation box and hence expanded its use with an aim to reduce COVID-19 exposure. TECHNIQUE: Vacuum suction tubing was attached to wall mount, and the other end of tubing was fixed, using adhesive surgical tapes, to the inside of the roof of barrier enclosure. Keeping the vacuum suction switched-on inside the box created a negative pressure while overall air flow is into the box from outside. This led us to believe that aerosols if generated are not contaminating patient's vicinity. Currently, we are using barrier enclosure boxes on all patients who are on noninvasive support (noninvasive ventilation or high-flow oxygen therapy). CONCLUSION AND CLINICAL SIGNIFICANCE: We believe that adding barrier enclosure with the above-mentioned negative-pressure modification will provide an opportunity to use noninvasive support widely, while at the same time, HCW's exposure to aerosols will be reduced. HOW TO CITE THIS ARTICLE: Kumar P, Chaudhry D, Lalwani LK, Singh PK. Modified Barrier Enclosure for Noninvasive Respiratory Support in COVID-19 Outbreak. Indian J Crit Care Med 2020;24(9):835–837.