Utility of bronchoscopy safety box-barrier to COVID-19 among healthcare workers

ABSTRACT

RATIONALE COVID-19 pandemic has infected millions with a high mortality rate worldwide. There is need of protecting healthcare workers (HCWs) from SARS-CoV-2 while treating patients. We designed, developed and analysed effectiveness of a physical barrier called bronchoscopy safety box (BSB) to prevent COVID-19 transmission to HCFs while doing bronchoscopy procedures and endotracheal intubation. METHOD: Two prototypes of Bronchoscopy safety box (BSBs) viz., prototype 1 (figure 2a) and prototype 2 (figure 2b), was developed (made up of acrylic and PVC sheets). BSB include the additional presence of the bronchoscopy aperture and an assistant aperture. In prototype 1, each aperture has a PVC valve which opens and closes with entry and exit of the hands while instead of PVC valves, there are gloves attached at the Doctor's and assistant aperture in Prototype 2 which minimizes risk of aerosol coming out of these apertures. There is negative suction port which is important in reducing the aerosol content inside the BSB. The patient end has PVC sheet curtains to accommodate shoulders/chest of patients that further minimises aerosol transmission. The box is easy to disinfect with 70% alcohol or bleach. Bronchoscopy procedures (foreign body removal, balloon bronchoplasty, endobronchial ultrasound, bronchial washings) and intubation was done with BSBs in 20 patients.RESULT: We were able to manoeuvre the bronchoscope and navigate up to the right lower lobe bronchus and left lower bronchus without any difficulty. The intubation procedure was performed comfortably with the BSB. 10 bronchoscopy procedures were performed with the Prototype 1 while 6 bronchoscopy procedures and 4 intubation procedures were performed with Prototype 2. CONCLUSION: BSB is a reusable, multi-purpose aerosol safety barrier which can be utilized for bronchoscopy procedures and intubation to help protect HCWs against COVID-19. .