ABSTRACT
The outbreak of COVID-19 has caused a worldwide pandemic. The widespread infection of the medical staff has caused great attention from all quarters of society. There is a particular concern when considering intubation treatment in the emergency operating room, where a significant amount of virus droplets are typically spread within the room, exposing the medical staff to a high risk of infection. Hence, there is currently a pressing need to develop an effective protection mechanism for the medical staff to prevent them from being infected during routine work. In order to understand the spread of droplets and aerosols when different oxygen supply devices are used for intubation therapy, this study uses particle image velocimetry (PIV) technology to analyze the airflow distribution between the medical staff and the patient. In the experiment, a simple version of the respirator was established to reproduce the breathing of human lungs. This model used oil to create smoke as a tracer aerosol, then a high-sensitivity camera was used to record the scattering light from this smoke (which is irradiated by the green laser sheet). Ultimately, after applying post-processing techniques, the airflow distribution is analyzed. PAO aerosol is the primary aerosol source in this experiment, and it is used to quantify the patient’s breathing;the concentration of PAO aerosol was measured at three different points: head, trunk, and feet. In addition, flow field visualization can effectively present the flow field distribution of the entire operating room;also, the results can be mutually verified with the PAO concentration measurement results. Aerosol concentrations were measured for six different oxygen supply devices with various tidal volumes of the artificial respirator, and the results were ranked from high to low concentrations for different oxygen supply devices and their operational oxygen supply flowrates: HFNC (70 l/min) > CPAP (40 l/min) > HFNC (30 l/min) > nasal cannula (15 l/min) > NRM (15 l/min) > VAPOX (28 l/min).
ABSTRACT
PURPOSE: To investigate the effectiveness of aerosol clearance using an aerosol box, aerosol bag, wall suction, and a high-efficiency particulate air (HEPA) filter evacuator to prevent aerosol transmission. METHODS: The flow field was visualized using three protective device settings (an aerosol box, and an aerosol bag with and without sealed working channels) and four suction settings (no suction, wall suction, and a HEPA filter evacuator at flow rates of 415 liters per minute [LPM] and 530 LPM). All 12 subgroups were compared with a no intervention group. The primary outcome, aerosol concentration, was measured at the head, trunk, and foot of a mannequin. RESULTS: The mean aerosol concentration was reduced at the head (p < 0.001) but increased at the feet (p = 0.005) with an aerosol box compared with no intervention. Non-sealed aerosol bags increased exposure at the head and trunk (both, p < 0.001). Sealed aerosol bags reduced aerosol concentration at the head, trunk, and foot of the mannequin (p < 0.001). A sealed aerosol bag alone, with wall suction, or with a HEPA filter evacuator reduced the aerosol concentration at the head by 7.15%, 36.61%, and 84.70%, respectively (99.9% confidence interval [CI]: -4.51-18.81, 27.48-45.73, and 78.99-90.40); trunk by 70.95%, 73.99%, and 91.59%, respectively (99.9% CI: 59.83-82.07, 52.64-95.33, and 87.51-95.66); and feet by 69.16%, 75.57%, and 92.30%, respectively (99.9% CI: 63.18-75.15, 69.76-81.37, and 88.18-96.42), compared with an aerosol box alone. CONCLUSIONS: As aerosols spread, an airtight container with sealed working channels is effective when combined with suction devices.