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Published in: Patient Safety in Surgery 1/2020

Open Access 01-12-2020 | SARS-CoV-2 | Hypothesis

Introducing the “Corona Curtain”: an innovative technique to prevent airborne COVID-19 exposure during emergent intubations

Authors: Eric Hill, Christopher Crockett, Ryan W. Circh, Frank Lansville, Philip F. Stahel

Published in: Patient Safety in Surgery | Issue 1/2020

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Abstract

Background

The coronavirus disease 2019 (COVID-19) pandemic places healthcare workers at risk of exposure to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Emergency department (ED) staff are particularly vulnerable when managing patients with acute respiratory distress due to the aerosolization of the virus during endotracheal intubation. A simple and innovative intubation tent was designed with the intent of decreasing the risk of accidental viral transmission from emergent intubations during the COVID-19 pandemic.

Presentation of technique

The materials and assembly process of the novel “Corona Curtain” are described in technical detail, with the intent of allowing other providers to template the concept at their respective facilities.

Results

A total of 36 intubation tents were mounted in the ED at the Medical Center of Aurora, Colorado, on April 7, 2020, and thereafter consistently used for all intubations during the ongoing COVID-19 outbreak. The cost of raw materials and labor for the initial assembly averaged US $ 8.00 per construct. The price of the single-use plastic cover is variable depending on the vendor source.

Conclusion

The new “Corona Curtain” was designed to improve the safety of ED staff when performing urgent/emergent intubations during the current COVID-19 pandemic. The concept can easily be adopted to other patient care areas, including perioperative and intensive care units. Future validation studies are needed to determine the safety and efficacy of the intubation tents by quantifying the pre−/post-intubation exposure through “point-of-care” SARS-CoV-2 testing once these resources are more widely available.
Literature
3.
go back to reference Heinzerling A, Stuckey MJ, Scheuer T, Xu K, Perkins KM, Resseger H, Magill S, Verani JR, Jain S, Acosta M, Epson E. Transmission of COVID-19 to health care personnel during exposure to a hospitalized patient – Solano County, California, February 2020. MMWR Morb. Mortal. Wkly. Rep. 2020;69:472–6.CrossRefPubMedPubMedCentral Heinzerling A, Stuckey MJ, Scheuer T, Xu K, Perkins KM, Resseger H, Magill S, Verani JR, Jain S, Acosta M, Epson E. Transmission of COVID-19 to health care personnel during exposure to a hospitalized patient – Solano County, California, February 2020. MMWR Morb. Mortal. Wkly. Rep. 2020;69:472–6.CrossRefPubMedPubMedCentral
4.
go back to reference Bialek S, Boundy E, Bowen V, Chow N, Cohn A, Dowling N, Ellington S, Gierke R, Hall A, MacNeil J, Patel P, Peacock G, Pilishvili T, Razzaghi H, Reed N, Ritchey M, Sauber-Schatz E, (CDC COVID-19 Response Team). Severe outcomes among patients with coronavirus disease 2019 (COVID-19) – United States, February 12-March 16, 2020. MMWR Morb. Mortal. Wkly. Rep. 2020;69:343–6.CrossRefPubMedCentral Bialek S, Boundy E, Bowen V, Chow N, Cohn A, Dowling N, Ellington S, Gierke R, Hall A, MacNeil J, Patel P, Peacock G, Pilishvili T, Razzaghi H, Reed N, Ritchey M, Sauber-Schatz E, (CDC COVID-19 Response Team). Severe outcomes among patients with coronavirus disease 2019 (COVID-19) – United States, February 12-March 16, 2020. MMWR Morb. Mortal. Wkly. Rep. 2020;69:343–6.CrossRefPubMedCentral
5.
go back to reference Burrer SL, de Perio MA, Hughes MM, Kuhar DT, Luckhaupt SE, McDaniel CJ, Porter RM, Silk B, Stuckey MJ, Walters M, (CDC COVID-19 Response Team). Characteristics of health care personnel with COVID-19 –United States, February 12-April 9, 2020. MMWR Morb. Mortal. Wkly. Rep. 2020;69:477–81.CrossRefPubMedCentral Burrer SL, de Perio MA, Hughes MM, Kuhar DT, Luckhaupt SE, McDaniel CJ, Porter RM, Silk B, Stuckey MJ, Walters M, (CDC COVID-19 Response Team). Characteristics of health care personnel with COVID-19 –United States, February 12-April 9, 2020. MMWR Morb. Mortal. Wkly. Rep. 2020;69:477–81.CrossRefPubMedCentral
6.
go back to reference Guo R, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, Tan KS, Wang DY, Yan Y. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Mil Med Res. 2020;7:11.PubMedPubMedCentral Guo R, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, Tan KS, Wang DY, Yan Y. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Mil Med Res. 2020;7:11.PubMedPubMedCentral
7.
go back to reference Bahl P, Doolan C, de Silva C, Chughtai AA, Bourouiba L, MacIntyre CR. Airborne or droplet precuations for health workers treating COVID-19? J. Infect. Dis. 2020; [April 16, Epub ahead of print]. Bahl P, Doolan C, de Silva C, Chughtai AA, Bourouiba L, MacIntyre CR. Airborne or droplet precuations for health workers treating COVID-19? J. Infect. Dis. 2020; [April 16, Epub ahead of print].
9.
go back to reference Wilson NM, Norton A, Young FP, Collins DW. Airborne transmission of serve acute respiratory syndrome coronavirus-2 to healthcare workers: a narrative review. Anaesthesia. 2020; [April 20, Epub ahead of print]. Wilson NM, Norton A, Young FP, Collins DW. Airborne transmission of serve acute respiratory syndrome coronavirus-2 to healthcare workers: a narrative review. Anaesthesia. 2020; [April 20, Epub ahead of print].
10.
go back to reference Cook TM. Personal protective equipment during the COVID-19 pandemic – a narrative review. Anaesthesia, 2020. [April 4, Epub ahead of print]. Cook TM. Personal protective equipment during the COVID-19 pandemic – a narrative review. Anaesthesia, 2020. [April 4, Epub ahead of print].
11.
go back to reference Ferioli M, Cisternino C, Leo V, Pisani L, Palange P, Nava S. Protecting healthcare workers from SARS-CoV-2 infection: practical indications. Eur Respir Rev. 2020;29:200068.CrossRefPubMedPubMedCentral Ferioli M, Cisternino C, Leo V, Pisani L, Palange P, Nava S. Protecting healthcare workers from SARS-CoV-2 infection: practical indications. Eur Respir Rev. 2020;29:200068.CrossRefPubMedPubMedCentral
12.
go back to reference Kluge S, Janssens U, Welte T, Weber-Carstens S, Marx G, Karagiannidis C. German recommendations for critically ill patients with COVID-19. Med. Klin. Intensivmed. Notfmed. 2020; [April 14, Epub ahead of print]. Kluge S, Janssens U, Welte T, Weber-Carstens S, Marx G, Karagiannidis C. German recommendations for critically ill patients with COVID-19. Med. Klin. Intensivmed. Notfmed. 2020; [April 14, Epub ahead of print].
13.
go back to reference Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can. J. Anaesth. 2020; [Feb 12, Epub ahead of print]. Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can. J. Anaesth. 2020; [Feb 12, Epub ahead of print].
14.
go back to reference Rubinstein CD, DenHartog EA, Deaton AS, Bogerd CP, DeKant S. Fluid replacement advice during work in fully encapsulated impermeable chemical protective suits. J Occup Envrion Hyg. 2017;14:448–55.CrossRef Rubinstein CD, DenHartog EA, Deaton AS, Bogerd CP, DeKant S. Fluid replacement advice during work in fully encapsulated impermeable chemical protective suits. J Occup Envrion Hyg. 2017;14:448–55.CrossRef
15.
go back to reference Tseng JY, Lai HY. Protecting against COVID-19 aerosol infection during intubation. J Chin Med Assoc. 2020. [Epub ahead of print]. Tseng JY, Lai HY. Protecting against COVID-19 aerosol infection during intubation. J Chin Med Assoc. 2020. [Epub ahead of print].
16.
go back to reference Zhang L, Li J, Zhou M, Chen Z. Summary of 20 tracheal intubations by anesthesiologists for patients with severe COVID-19 pneumonia: retrospective case series. J. Anesth. 2020; [April 17, Epub ahead of print]. Zhang L, Li J, Zhou M, Chen Z. Summary of 20 tracheal intubations by anesthesiologists for patients with severe COVID-19 pneumonia: retrospective case series. J. Anesth. 2020; [April 17, Epub ahead of print].
17.
go back to reference Kearsley R. Consensus guidelines for managing the airway in patients with COVID-19. Anaesthesia. 2020; [April 20, Epub ahead of print]. Kearsley R. Consensus guidelines for managing the airway in patients with COVID-19. Anaesthesia. 2020; [April 20, Epub ahead of print].
18.
go back to reference Cook TM, El-Boghdadly K, McGuire B, McNarry AF, Patel A, Higgs A. Consensus guidelines for managing the airway in patients with COVID-19: guidelines from the Difficult Airway Society, the Association of Anaesthetists, the Intensive Care Society, the Faculty of Intensive Care Medicine, and the Royal College of Anaesthetists. Anaesthesia. 2020; [March 27, Epub ahead of print]. Cook TM, El-Boghdadly K, McGuire B, McNarry AF, Patel A, Higgs A. Consensus guidelines for managing the airway in patients with COVID-19: guidelines from the Difficult Airway Society, the Association of Anaesthetists, the Intensive Care Society, the Faculty of Intensive Care Medicine, and the Royal College of Anaesthetists. Anaesthesia. 2020; [March 27, Epub ahead of print].
19.
go back to reference Berkow LC, Morey TE, Urdaneta F. The technology of video laryngoscopy. Anesth Analg. 2018;126:1527–34.CrossRefPubMed Berkow LC, Morey TE, Urdaneta F. The technology of video laryngoscopy. Anesth Analg. 2018;126:1527–34.CrossRefPubMed
21.
go back to reference Firstenberg MS, Libby M, Ochs M, Hanna J, Mangino JE, Forrester J. Isolation protocol for a COVID-2019 patient requiring emergent surgical intervention: a case report. Patient Saf. Surg. 2020;14:15.CrossRefPubMedPubMedCentral Firstenberg MS, Libby M, Ochs M, Hanna J, Mangino JE, Forrester J. Isolation protocol for a COVID-2019 patient requiring emergent surgical intervention: a case report. Patient Saf. Surg. 2020;14:15.CrossRefPubMedPubMedCentral
22.
go back to reference Wen X, Li Y. Anesthesia procedure of emergency operation for patients with suspected or confirmed COVID-19. Surg Infect. 2020;21:299.CrossRef Wen X, Li Y. Anesthesia procedure of emergency operation for patients with suspected or confirmed COVID-19. Surg Infect. 2020;21:299.CrossRef
23.
go back to reference Rahimi F, Bezmin Abadi AT. Challenges of managing the asymptomatic carriers of SARS-CoV-2. Travel Med. Infect. Dis. 2020; [April 18, Epub ahead of print]. Rahimi F, Bezmin Abadi AT. Challenges of managing the asymptomatic carriers of SARS-CoV-2. Travel Med. Infect. Dis. 2020; [April 18, Epub ahead of print].
24.
go back to reference Zareifopoulos N, Lagadinou M, Karela A, Karantzogiannis G, Velissaris D. Intubation and mechanical ventilation of patients with COVID-19: what should we tell them? Monaldi Arch Chest Dis. 2020;90:1. Zareifopoulos N, Lagadinou M, Karela A, Karantzogiannis G, Velissaris D. Intubation and mechanical ventilation of patients with COVID-19: what should we tell them? Monaldi Arch Chest Dis. 2020;90:1.
25.
go back to reference Giwa AL, Desai A, Duca A. Novel 2019 coronavirus SARS-CoV-2 (COVID-19): an updated overview for emergency clinicians. Emerg Med Pract. 2020;22:1–28.PubMed Giwa AL, Desai A, Duca A. Novel 2019 coronavirus SARS-CoV-2 (COVID-19): an updated overview for emergency clinicians. Emerg Med Pract. 2020;22:1–28.PubMed
Metadata
Title
Introducing the “Corona Curtain”: an innovative technique to prevent airborne COVID-19 exposure during emergent intubations
Authors
Eric Hill
Christopher Crockett
Ryan W. Circh
Frank Lansville
Philip F. Stahel
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Patient Safety in Surgery / Issue 1/2020
Electronic ISSN: 1754-9493
DOI
https://doi.org/10.1186/s13037-020-00247-5

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