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Br J Radiol ; 95(1129): 20210835, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1575206


OBJECTIVE: To evaluate the efficacy of a barrier shield in reducing droplet transmission and its effect on image quality and radiation dose in an interventional suite. METHODS: A human cough droplet visualisation model in a supine position was developed to assess efficacy of barrier shield in reducing environmental contamination. Its effect on image quality (resolution and contrast) was evaluated via image quality test phantom. Changes in the radiation dose to patient post-shield utilisation was measured. RESULTS: Use of the shield prevented escape of visible fluorescent cough droplets from the containment area. No subjective change in line-pair resolution was observed. No significant difference in contrast-to-noise ratio was measured. Radiation dosage to patient was increased; this is predominantly attributed to the increased air gap and not the physical properties of the shield. CONCLUSION: Use of the barrier shield provided an effective added layer of personal protection in the interventional radiology theatre for aerosol generating procedures. ADVANCES IN KNOWLEDGE: This is the first time a human supine cough droplet visualisation has been developed. While multiple types of barrier shields have been described, this is the first systematic practical evaluation of a barrier shield designed for use in the interventional radiology theatre.

Infectious Disease Transmission, Patient-to-Professional/prevention & control , Protective Devices , Radiology, Interventional/instrumentation , Adult , COVID-19/transmission , Cough , Equipment Design , Fluorescence , Humans , Male , Phantoms, Imaging , Radiation Dosage , Signal-To-Noise Ratio , Supine Position
Br J Anaesth ; 126(2): 544-549, 2021 02.
Article in English | MEDLINE | ID: covidwho-934893


BACKGROUND: Hazardous pathogens are spread in either droplets or aerosols produced during aerosol-generating procedures (AGP). Adjuncts minimising exposure of healthcare workers to hazardous pathogens released during AGP may be beneficial. We used state-of-the-art computational fluid dynamics (CFD) modelling to optimise the performance of a custom-designed shield. METHODS: We modelled airflow patterns and trajectories of particles (size range 1-500 µm) emitted during a typical cough using CFD (ANSYS Fluent software, Canonsburg, PA, USA), in the presence and absence of a protective shield enclosing the head of a patient. We modelled the effect of different shield designs, suction tube position, and suction flow rate on particle escape from the shield. RESULTS: Use of the shield prevented escape of 99.1-100% of particles, which were either trapped on the shield walls (16-21%) or extracted via suction (79-82%). At most, 0.9% particles remained floating inside the shield. Suction flow rates (40-160 L min-1) had no effect on the final location of particles in a closed system. Particle removal from within the shield was optimal when a suction catheter was placed vertically next to the head of the patient. Addition of multiple openings in the shield reduced the purging performance from 99% at 160 L min-1 to 67% at 40 L min-1. CONCLUSION: CFD modelling provides information to guide optimisation of the efficient removal of hazardous pathogens released during AGP from a custom-designed shield. These data are essential to establish before clinical use, pragmatic clinical trials, or both.

COVID-19/transmission , Hydrodynamics , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Models, Theoretical , Occupational Exposure/prevention & control , Personal Protective Equipment , Aerosols , Cough/virology , Equipment Design , Health Personnel , Humans